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CLIMATOLOGY OF FLORIIJ' 



BY 



CHARLES J. KENWORTHY, M. D., 



JACKSONVILLE, FLA., 



PRESIDENT FLORIDA MEDICAL ASSOCIATION ; PRESIDENT DUVAL COUNTY 
MEDICAL ASSOCIATION ; LATE SENIOR SURGEON BALLARAT HOS- 
PITAL AND PHYSICIAN TO BALLARAT BENEVOLENT ASY- 
LUM, VICTORIA, AUSTRALIA. 



Reprint from Transactions Florida Medical AssoaATioK, 
Session of 1880. 



SAVANNAH; 

UOSNXMO KBWa BTEAM PBIMTIi7<3 HOTTSBi 
1889. 



/3y<fJ 
PREFACE. 



At a recent meeting of the Florida Medical Association, a 
paper was read on the Climatology of Florida, by Dr. C, J. 
Kenworthy, the President, which attracted very general 
attention. The information which it contains is not only 
valuable, but it is presented in so forcible a style that we 
were anxious to have it disseminated through a wider sphere 
than could be reached by its publication in the proceedings 
of a medical society. We therefore applied to Dr. Ken- 
worthy for permission to republish it and distribute it 
among the thousands throughout the Northern and Western 
States who seek a warmer winter climate. This permission 
was kindly granted, and the author has also taken the 
opportunity to introduce some statistics that were not avail- 
able at the time the paper was originally published. 

To the annual visitor to Jacksonville, the name of Dr. 
Kenworthy will be sufi&cient to attract attention to anything 
from his pen. To those who do not know him, we will say 
that he adds to his high standing and long experience as a 
physician in New York city, in Australia and in Jackson- 
ville, that thorough acquaintance with the forests and 
streams of Florida, which can only be acquired as an ardent 
votary of the rod and gun. 



i ' 



.]P 



CLIMATOLOGY OF FLORIDA. 



BY CHARLES J. KENWOETHY, M. D., JACKSONVILLE, FLORIDA. 



Mr. President and Gentlemen : 

The President, Dr. Daniel, appointed me one of the 
essayists on this occasion, and I have selected as a subject 
for a few remarks, the Climatology of Florida, with United 
States and Continental comparisons. In treating this sub- 
ject, I shall not aim at originality. In the language of Dr. 
Lente, of New York, " I make the attempt to enlighten the 
public, more especially the medical public, on the subject of 
the Climate of Florida, its adaptability as a health resort, 
and especially to remove certain unfounded ideas and preju- 
dices which have been wide spread and deeply rooted in 
Northern communities. It is somewhat surprising that this 
should be the case with medical men, since positive informa- 
tion on the subject has always been accessible to them in 
the volumes of the Medical Statistics of the United States 
Army, the Army Medical Reports, and the Reports of the 
Adjutant General's Office."* 

As evidence that such ignorance does prevail among edu- 
cated medical men regarding climate, I quote from recent 
writers. 

Dr. Denison remarks : " Of American climates of low 
elevation, we have the resorts of moist and sedative Flor- 
ida."f If this gentleman had familiarized himself with the 
meteorology of Florida, he would have written : '•' Portions 
of Florida possess a dry and bracing climate, while some 
localities are more moist and sedative." 

Dr. Napheys uses the following language : " Lower dry 
climates : Cannes, Mentone, Minnesota, Northern Georgia." 
"Lower damp climates — Florida : moist, changeable."^ 

But the facts in the case, if reliable observations are to 
be accepted, are the opposite of what Dr. Napheys has 
asserted. The mean relative humidity of the localities re- 
ferred to, for the cold months, is as follows : 

♦Constituents of Climate, Louisville Medical Journal, Aug., 1878. 

t Rocky Mountain Health Kesoits, by Charles Denison, A. M., i/L 
D., Boston, 1880, p 13. 

t Modern Medical Therapeutics, by G. A. Napheys, M. D., Phila- 
delphia, 1880, p. 193. 



Cannes and Mentone*... 

Augusta, Ga.t 

Breckenridge, Minn, f . .. 

Duluth, Minn.f 

St. Paul, Minn.t-.. 

Jacksonville, tla.f 

Key West Fla f 

Punta Rassa, Fla f 



§3 


fi 




>> 




fc; DO 


^ 


^ 


>> 


b 




^■° 


a 


e 


^ 


D 


jH 


« o 


p 


01 




ti 


o 


9 o 


c 




a 


J3 


^ 
^ 


« a 


prct. 


prct. 


prct. 


prct. 


prct. 


prct. 


71.8 


74 2 


72.0 


70.7 


73.3 


72.4 


71 8 


72.6 


73.0 


64.7 


62.8 


68.9 


76.9 


83.2 


76 8 


81 8 


79.5 


79.6 


74.0 


72.1 


72.7 


73.3 


71.0 


72.6 


70.3 


73. -> 


7.5.2 


70.7 


67.1 


714 


71.9 


6!) 3 


70 2 


6.S.5 


63.9 


68.8 


77.1 


78.7 


78. i) 


77.2 


72.2 


76.8 


72.7 


73.2 


74.2 


73.7 


69.9 


72.7 



§3 



pr ct. 



- 74.4 



\ 



72.7 



From the above data, it appears that the mean relative 
humidity of Cannes and Mentone, during the cold months, 
exceeds that of Jacksonville by nearly four per cent. Three 
stations in Minnesota have a mean of 74.4, and three in 
Florida a mean of 72.7, showing a per cent, of 1.6 in favor 
of Florida, and 5.6 per cent, in favor of Jacksonville over 
Minnesota. 

Dr. Talbot Jones, of St. Paul, Minnesota, in an essay 
published in the New York Medical Journal, September, 
1879, says : "The injurious effects of a moist atmosphere 
have been alluded to. By referring to the foregoing meteo- 
rological tables, it will be observed that the atmosphere of 
this State (Minnesota) is remarkably free from moisture. 
Hygrometric measurements show that the atmosphere of 
that State (Florida) is loaded with moivsture." 

Dr. Jones learnedly discusses " Hygrometric measure- 
ments" and "that State loaded with moisture," neglects to 
favor his readers with a reliable "table" referring to the hu- 
midity of Florida. Simple assertions, " as that State loaded 
with moisture," are unprofessional and unreliable. 

If we take the entire year, for a period of five years, we 
will find but httle difference in the mean relative humidity 
of Minnesota and Florida, as the following data, kindly 
furnished us by the Chief Signal Officer of the United States 
Army, will demonstrate : 

*The Riveira, E. J. Sparks, M. D., London, 1879, p. 9. 
f Signal Office Reports. 





. Minnesota. 


Florida. 


Years. 


d • 

■ a> « 




1 


4) 

a 

o 

m 

M 


"S 

3 


00 


1875 


prct. 
75.7 
67.7 
72.2 
76.2 
74.1 


pr ct. 
67.2 
68.2 
71.9 
71.5 
72.8 


prct. 
69.0 
69.1 
67.6 
67.7 
65.3 


prct. 
70.8 
67.2 
69.3 
68.7 
69.7 


prct. 
76.0 
73.9 
70.5 
72.4 
72.3 


prct. 
71 5 


1876 


70 1 


1877 


74 1 


1878 


74 5 


1879 


74 2 






Mean for 5 years 


73.2 


70.3 


67.7 


69.0 


73.0 


74.1 




Mean for five years for 
States 


70.4 




72.0 









From the above reliable " data," it will be found that the 
"atmosphere of Florida," although "loaded with moisture," 
contains, for the year, but 1 6-10 per cent, of moisture in 
excess of the " dry and desiccating " climate of Minnesota. 
During the five cold months, the mean relative humidity of 
Florida is less than that of Minnesota, and if we accept as 
conclusive, the " hygrometric measurements" and statements 
of Dr. Jones, Minnesota is not a suitable climatic resort for 
invalids during the winter months, for its relative mean 
liumidity is greater than that of Florida, and more especially 
that of Jacksonville, which he specially condemns, on the 
ground that the atmosphere is "loaded with moisture." 
The mean relative humidity of St. Paul exceeds that of 
Jacksonville for the five cold months by 2.6 per cent. 

Natural remedial agents, as climate and mineral waters, 
are attracting much attention, and reliable data regarding 
them should be placed before the profession and the public. 
In the language of Dr. Madden, Physician to St. Joseph's 
Hospital, Dublin, "Notwithstanding the number of recent 
works on the subject, there is a great deficiency of accurate 
information concerning even the most frequented health 
resorts. For the majority of such books, being written 
either by those residing in some sanitarium, the, advantages 
of which are unconsciously exaggerated, or else being merely 
copied from their local advertisements, physicians at home 
iare often misled, and the patients suffer the consequences. 
He who would attempt to supply the want of a comprehen- 



■6 

sive and reliable guide to health resorts, should have per- 
sonal experience in many climes and places, and himself be 
a physician."* 

Difference of opinion exists in the profession regarding 
the effects of climate in the treatment of pulmonary and other 
diseases. Having been a member of the profession for 
over the third of a century, and having treated disease in 
private practice, as well as in several hospitals in the United 
tetates and in other lands, I have reason to believe that I 
am justified in expressing mine. My reason for settling in 
this State was my wife's health. She was a sufferer from 
phthisis, aggravated by a Northern climate. From my per- 
sonal knowledge of the climatic advantages of this State, 
acquired by frequent visits, the first in 1844, 1 resolved upon 
settling in this city. As a result of change of climate, com- 
bined with rational medication, my wife was restored to 
health. In 1849, I was connected with Bellevue and Black- 
well's Island Hospitals, New Yorli, and contracted typhoid 
fever and cholera, followed by post mortem poisoning, and 
impaired health was the result. Tracing my family history, 
I found that my mother and fourteen of her brothers and 
sisters had died of phthisis. With impaired health, a laryn- 
geal affection and a hereditary predisposition to tubercu- 
losis, I had anything but a bright prospect before me. I 
looked to clima e as my sheet anchor, and sailed for Aus- 
tralia ; and a dry and warm climate improved my health, 
and to-day, as you can all perceive, I am in the enjoyment 
of as good health as usually falls to the lot of men of my 
age. After a permanent residence in this State of nearly 
six years, I am convinced of its healthfulness and the supe- 
riority of its climate, and deem myself warranted in express- 
ing an opinion. 

When invalids visit a Southern clime, they expect to find 
perpetual spring, and a climate made to order, '' a wonder- 
ful paradise, and cry out like naughty children when theii; 
delusion is exploded." But a model climate does not exist, 
and no country is perfect in this respect. The physician's 
object should be to select for his patients the situation pre- 
senting the greatest advantages and the fewest objectionable 
features for the case under consideration. Annually, pa- 
tients migrate to health resorts merely to find a grave, as a 
sequence of being sent from home when beyond the hope 
of cure, or because " a situation unfavorable to the particular 
malady has been selected, the laws of climate being ill un- 

* Health Resorts— T. M. Madden, M. D., 1876, p 7. 



derstood, and in some measure, because it is difficult to 
persuade the sick that simple change from one climate to 
another country or section, is only one of the means by which 
they are to regain their health. For, although there can be 
no doubt that in change of air, physicians have an efficient 
remedial agent, yet it is certain that this remedy, like all 
others, is not of indiscriminate application, but must be pre- 
scribed with judgment."* "Of the large and annually 
increasing number of invalids, more especially consumptive 
patients, who are now sent abroad to winter in vapious 
health resorts, probably as many are injured by a wrong or 
by too tardy a change of climate, as are saved by the timely 
and judicious use of this most valuable remedy. Patients, 
as a rule, will not abandon the comforts of home, or the 
avocations of their life, so long as they can cling to them, 
nor do physicians generally prescribe this step until other 
treatment has failed, and then, when perhaps the disease is' 
far advanced, the patient may be induced to try a change 
of climate as a last resource."f 

What climate shall be chosen for the invalid, is a matter 
of vital importance, and an error in this direction may be 
fatal. In some instances, neither physicians nor patients 
ftiUy appreciate the necessity of deciding correctly and 
abiding by the decision. Invalids are often imprisoned in 
some secluded spot, which happens to be brought promi- 
nently before them or their physicians by a well written 
pamphlet, when a frequent change of air would have been 
beneficial to them, and when the moral effect of change of 
scene would have been more useful. On the other hand, 
those who require rest and quiet are allowed to rush wildly 
along and pass the greater part of their time in traveling. 
Others are consigned to a cold, damp and changeable cli- 
mate, when they require the opposite. Some are sent to a 
tropical and moist climate, when they would be benefited 
by a moderate, dry and bracing one. Dr. Brinton, of Phil- 
adelphia, has aptly, yet bluntly, presented this subject, and 
we shall quote his language : "And here I must say with 
all due deference to the faculty, that the ignorance and care- 
lessness of physicians in reierence to this matter are, at 
most, reprehensible. Few of them make any distinction in 
cases. They send all consumptives to Minnesota, or to 
Texas, or to Cuba, or Florida, as if in every instance what 
is sauce for the goose is sauce for the gander. Thus it hap- 

♦Tanner's Practice of Medicine, p. 7S2. ■ 

f Health Eesorts — Madden, p. 1. .«ia ;i 



8 

pens, that the most eligible climates gain a bad reputation. 
When a medical man recommends a climate and yet is una- 
ble to tell its temperature, its moisture, its prevailing winds, 
its seasons, its local diseases, its articles of food, its accom- 
modations for travelers — beware of him — he is a dangerous 
counselor. These facts the physician must know to advise 
wisely. Constitutions are differently affected by climate, 
and so are cases of the same disease. Some chmates are 
sedative and relaxing ; othei's tonic and bracing ; some are 
moist and soothing ; others dry and steeling. Some consti- 
tutions are nervous and irritable ; others torpid and sluggish; 
some have plenty of latent force, which needs use ; in others, 
the vital powers are naturally weak and must be carefully 
husbanded. In some cases, the syrpptoms are of inflamma- 
tory ; in others, of an atonic character. In some, the secre- 
tions are scanty ; in others, profuse. In some, considera- 
tions of diet are of great importance ; in others, they do not 
enter. In some, the cough is importunate ; in others, 
scarcely annoying, and a hundred other differences might 
be added. The question is a complicated one. It asks, for 
its solution, the utmost care of the physician. It almost 
demands the trained skill of a specialist."* 

In this age of rapid, cheap and comfortable traveling, the 
advantages to health of a change of climate should be con- 
sidered by every person suffering from pulmonary or chronic 
disease, or broken health. It is a pleasant, and in many 
cases, a valuable remedy, if judiciously advised. " It would 
be difficult," says Sir James Clark, the standard authority 
on climate, " to point out the chronic complaint, or even 
disordered state of health which is not benefited by a timely 
and judicious change of climate." The diseases most likely 
to be benefited or cured by change of climate, are phthisis, 
laryngeal and bronchial affections, asthma, disorder of the 
digestive organs, chronic gout and rheumatism, affections 
of the kidneys, and broken health. A change of climate is 
beneficial to strumous children, is invaluable during conva- 
lescence from acute and chronic disease, and more especially 
is it one of the chief resources of restorative medicine. 

A large majority of patients require a moderately warm, 
dry and bracing atmosphere, and the few demand a warm, 
sedative climate, where the atmosphere is not alone warm, 
but humid ; aad here steps in that knowledge that should 
be possessed by medical men who recommend climatic 



♦Florida and the South— D. G. Brinlon, M. D., Philadelphia, 1869, 
p. 120. 



change as a remedial agent. A moderately warm, dry and 
bracing air, with but few sudden and great atmospheric 
changes, is especially adapted to tuberculous disease in ita 
early stages, catarrh, chronic bronchiti:--, chronic rheuma- 
tism, debilitating mucous discharges, renal diseases, dys- 
pepsia, and some cases of asthma. A moist, warm and 
sedative climate is best adapted to many cases of advanced 
phthisis, dry asthma, chronic bronchitis, accompanied with 
great irritability of the pulmonary mucous membrane, and 
hard, dry cough. The particular locality, or what climate 
shall be chosen for a winter resort in any given case, is a 
matter of great importance, and should not be based on this 
or that letter or publication. Facts, figures, experience and 
favorable factors of climate should determine the question. 
An error in this direction may be fatal, and before a physi- 
cian advises a patient to resort to any particular locality, 
he should carefully investigate each particular case, arrive 
at a correct diagnosis, and familiarize himself with the fac- 
tors of each winter resort. Many an invalid who would be 
restored to comparative health, or at least survive for years, 
if he wintered in a temperate climate, is sent to a region 
where zero is frequently reached, where atmospheric changes 
are frequent and great, and where the patient is confined to 
heated rooms for days together, and debarred from taking 
exercise and enjoying the health-giving influence of sunlight 
and pure air. Others are sent to a warm and relaxing cli- 
mate, when they require a temperate, dry and bracing one. 
Fashion and the influence of some leading physician have 
much to do with this. 

In this active business country we find many persons who 
have been overworked and present a breach in the chain of 
those vital processes, whose continuity constitutes health — • 
a condition popularly known as "broken health." The 
physician is unable to point out any special abnormal con- 
dition of any particular organ. The invalid cannot picture 
his symptoms, for there is no marked pain, and no particu- 
lar function of life that is abnormal. The patient feels 
himself less capable than formerly of transacting the ordi- 
nary affairs of business ; little things annoy him ; a small 
amount of exercise tires him, his night's i-est is insufiicient, 
he suffers from distended bowels, he is uncomfortable after 
meals, symptoms of defective circulation are manifested, his 
knees and ankles become stiff, he has pains in the back and 
sides, the tongue is somewhat furred in the morning, the 
complexion loses its transparency, after a time slight deaf- 
ness or imperfection of vision occurs toward night ; ia spite 



10 

ef debility, the patient sometimes grows fat ; the nails be- 
come brittle ; the urine is generally pale and scanty, and, if 
examined microscopically, will frequently be found to con- 
tain numerous chrystals of oxylate of lime. In some 
instances, the sufferer applies to a physician, and as the 
symptoms are mainly negative, he is treated for " bilious- 
ness," "nervousness," or "dyspepsia," three convenient 
cloaks for professional ignorance. Failing to obtain relief, 
the patient flies to quack medicines, and tries "bitters," 
"liver regulators," and "mandrake pills." The patient is 
simply suffering from "broken health," or, more correctly 
speaking, " general degenerative diathesis." 

Unless judicious treatment is adopted, the heart becomes 
dilated, atheromatous change occurs in some of the arteries, 
cerebral throbbing, weakness and irregular action of the 
heart, atropic paralysis of a limb. Bright's disease, chronic 
bronchitis, chronic inflammation of the stomach or colon, or 
other serious affection becomes established. As local dis- 
eases, the sequence of broken health (general degenerative 
diathesis), proceed very slowly to an incurable stage, they 
give much encouragement to the medical man to hope for 
a cure, or at least the possibility of arresting diseased pro- 
cesses, and making the patient comfortable for years. The 
primary cause which seems to underlie the series of condi- 
tions and changes referred to, is weakness of the circulation, 
the result of overwork, sedentary occupations, anxiety of 
mind, debauchery, or laziness. To relieve such cases, cli- 
matic change, suitable exercise, fresh air, sunshine, absence 
from the harassing strain of business, proper food and 
rational medication are demanded. 

If such a course is adopted, in a limited period, the pulse 
will beat regularly and stronger ; the heart impulse will be 
felt by the hand ; insJead of prostration after exercise, there 
will be a healthy weariness ; cold sweats will cease, swelling 
pf the extremities will disappear, digestion will be properly 
performed, and in time the patient will be restored to health 
or comparative comfort. And in Florida, the worn-out man 
of business, suffering from "broken health," will find the 
necessary relaxation from " brain fag," opportunities to take 
out-docr exercise, plenty of sunshine, pure and bracing air, 
and other necessary adjuncts to relieve a condition affecting 
the many. In this connection, I cannot refrain from refer- 
ring to what I consider an important fact. From my 
observations in the United States and in foreign lands, and 
in hospital as well as private practice, I have been forced to 
notice the infrequeucy of chronic disease and broken health 



11 

in Florida. In my visits to various portions of this State, 
I have met with many persons, old and young, who live 
from year to year on improper food, and who drink water 
from shallow holes, near marshes, and yet, singular to say 
(although such persons are somewhat anaemic), they do not 
present any manifest diseased condition. In cities, towns, 
villages, and rural districts, where residents are supplied 
with proper food, and drink pure water, a case of chronic 
disease or broken health is seldom met with. And if we 
have a climate in which these conditions rarely occur, are 
we not justified in concluding that it will exert a powerful 
influence in restoring the invalid to health ? As most of 
you are aware, I have, at various times, visited many por- 
tions of the State, and have been surprised to meet so many 
persons who have settled in it as invalids and have been 
restored to health or comparative comfort by the chmate — 
a large proportion of them having been sufferers from pul- 
monary diseases. And what surprised me most, was the 
fact that none of their offspring manifested any constitu- 
tional predisposition to pulmonary disease. Independent of 
uterine diseases among females, so common in every civilized 
couutry, and constitutional syphilis among colored people, 
I will ask you if your experience will not bear out my state- 
ment, and if your practice among residents is not almost 
exclusively confined to acute and not chronic disease and 
broken health ? If this is a fact, it would appear that the 
climate is peculiarly adapted to the cure of such conditions, 
and have we not a potent agent to use, and if used aright, 
to benefit suffering humanity ? 

Many persons residing in the Northern and Western 
States suffer from what is known as winter cough — a cough 
limited to the winter season, or much aggravated by it. 
This troublesome symptom may be the result of bronchitis, 
emphysema, naso-pulmonary catarrh, follicular disease of 
the pharynx, chronic thickening of the pulmonary mucous 
membrane, or other pathological condition. The investi- 
gations of Drs. Dobel, Green, C. T. Williams, and Pollock, 
of London, and others, establish the fact that pulmonary 
consumption frequently results from one of the above con- 
ditions. Dr. C. T. Williams, Physician to the Brompton 
Hospital for Consumption, London, remarks : " A catarrh 
creeps down the bronchial mucous membrane and event- 
ually reaches some of the alveoU. fiere rapid proliferation 
of epithelium (lymphatic endothelium) occurs, which is the 
more irritated and prone to multiply, owing to the inhala- 
t:?? of some of the bronchial secretion. The alveoli becojjie 



12 

choked and stuffed with epithelium, and the vessels may be 
emptied through pressure ; ulceration may follow, and 
the whole mass may liquify, caseate and become expecto- 
rated."* 

From the rapid advances made in pulmonary pathology 
within the last decade, it is self-evident that something more 
is required of the medical man than the relief of cough or 
the administration of cod-liv3r oil and expectorants — that 
he should possess an accurate and exhaustive knowledge of 
pulmonary diseases, and treat diseased conditions and not 
symptoms. It is time that physicians abandoned the older 
doctrines of the specificity of tubercle and phthisis, which 
undoubtedly exercised an unfavorable influence upon treat- 
ment. Within a recent period, owing to accurate investi- 
gations, there has been a gradually increasing tendency to 
regard phthisis as an inflammatory affection, and there Las, 
consequently, been a corresponding tendency to attempt, 
by treatment, to prevent the occurrence and control the 
influence of bronchial and pulmonary inflammation. " We 
do not even yet," remarks Dr. Green, Physician to Charing 
Cross Hospital, "sufficiently recognize the fact that the 
development of phthisis is determined and the progress of 
the disease influenced by the ordinary causes of iuflamma- 
tion ; and the results of pathological investigation indicate, 
I thmk, the advisability of directing our treatment still more 
closely with the object of preventing and controlling all 
inflammatory processes in the lungs. Of all the teachings 
of our pathology, this is undoubtedly', by far, the most im- 
portant."f According to Hirsch, "This much is firmly 
established, that catarrhal affections of the respiratory 
organs, other things being equal, are the more frequent the 
farther we proceed from the tropics towards higher lati- 
tudes, and that the maximum of their frequency in different 
• portions of the frigid and temperate zones, is found in gen- 
eral, where frequent, sudden and severe variations of 
temperature occur, in addition to the prevalence of a moist 
and cold climate. "| When treating of bronchial catarrh, 
Dr. Riegel, Medical Director of the City Hospital of Cologne, 
says : *' It is not to be denied that there is a class of indi- 
viduals who, despite all precautionary measures, always 
become affected with catarrh after the slightest exposure 
and at every sudden change of weather. For such persons, 
• 1 — 

♦Clinical Lectures on Phthisis, delivered at Brompton Hospital, 
London. Brit, and For. Medical Journal, March, 1778. 

f Green on Consumption, London, 1878, p. 99. 

JHandb. Hist. Geograp. Path. Erlangen, 1862. 



13 

the choice of a tolerably mild residence, of equable temper- 
ature, often affords the only certain prophylactic. For 
persons who suffer from bronchial catarrh every winter, 
nothing can be recommended more urgently than resort to 
a milder climate for several winters. Many localities are 
suitable for this purpose, and in general, those are to be 
recommended which have been found suitable as winter 
residences for consumptives."* 

When any condition of the air passages exists calculated 
to induce phthisis, or when a marked predisposition is pres- 
ent, climatic change is worthy of consideration. Dr. Dobel, 
consulting physician to the Royal Hospital for Diseases of 
the Cbest, London, states that, "In 72 per cent, of cases of 
cough he had analyzed, he found the disease had been 
aggravated by fresh colds, caught either by, 1, sudden 
changes of temperature ; 2, fogs and damp air ; 3, draughts 
of cold air ; 4, getting wet ; 5, wet feet."f At p. 177, he 
remarks : " The tuberculous diathesis adds frightfully to 
the perils of all catarrhal affections and will claim our atten- 
tion on this account, rather than, a cause of winter cough. 
When the constitutional tendency to consumption is at all 
marked, we shall have to be constantly on our guard against 
the occurrence of local congestions and inflammatory attacks 
of catarrh, for ivhatemr increases the vascularitu of an internal 
organ in the tuberculous diathesis, involves the lisk of tuber- 
cularization of the affected part. And again, when we dis- 
cover physical signs of that lung-disintegraiion, which is 
one of the serious effects of repeated and neglected catarrhal 
attacks, grave as its importance must be allowed to be under 
the most favorable diathetic conditions, the co-existence of 
a tuberculous predisposition at once invests it with all the 
horrors of advancing consumption of the lungs, and will 
necessitate a change of climate entirely ruled by this con- 
sideration. To prevent the winter cough from running into 
consumption will be the first consideration, in the climate 
as well as in every other form of our treatment of the case." 
When referring to the influence of cyclical conditions as 
productive of phthisis. Dr. Smith, Physician to the Hospital 
for Diseases of the Chest, at Brompton, remarks : "The 
evils of the season [winter] will, however, be the tendency 
to internal congestion and inflammation, the increase of 
cough from irritation of pharynx and air passages, induced 
by the inhalation of cold air ; the tendency to haemoptysis 

♦Ziemsen's Encyclopedia of Prac. Med., pp. 410, 413. 
f Dobel on Cough and Consumption, 1877, p. 143. 



14 

-from increased cough, irritability of the mucous membrane 
and congestion of the lungs, a,nd deficiency of temperature 
from the cold. If a patient be restricted to an artificially 
heated atmosphere, he will have the evils of dryness, still- 
ness and impurity of the air. In selecting a foreign winter 
and early spring residence for the class of patients under 
consideration, we must seek for the conditions which will 
enable the patient to spend his time in the open air, and 
.such are the temperature, dryness of the air, and the 
violence of the winds. Speaking generally, those climates 
will be the most suitable in which the air is not moist, the 
temperature never very high nor tow, but uniformly sus- 
tained." * 

There is a period in man's existence when no actual dis- 
ease is present — when the body gradually yields to the 
advances of old age. With the majority, this occurs between 
the fiftieth and sixty-fifth years, and it has long been noticed 
that the winter months are especially dangerous to persons 
advanced in years. The following passage from the London 
Times and Gazette for February 22d, 1879, illustrates the 
action of a severe winter in causing mortality : "The quar- 
terly return of the Register General for the period ending 
December 31st, last, affords convincing proof of the fatal 
effects of the late severe winter upon all ages of the com- 
munity. Tlie largest proportional excess in mortality 
occurred among persons aged upwards of sixty years. The 
death rate at these ages was equal to 83.7 per 1,000, and 
was considerably higher than in any corresponding quarter 
■ since 1870. The death rate among persons aged upwards 
of sixty years, in the twenty large towns, during the Decem- 
ber quarter, averaged 89.6 per 1,000. Taking the mortality 
of the mild autumn quarter of 1877, as a standard of com- 
parison, the excess of mortality last quarter, due to the low 
temperature, may be stated in the following manner : Among 
persons of all ages, the excess was equal to 12.4 per cent.; 
it was 8.8 per cent, greater among infants under one year 
of age ; 7.8 among persons aged between one and sixty 
years, and so great as 24.7 among persons aged upwards of 
sixty years." 

Morbiiity, that is to say, the probability of becoming sick, 
is marked during the great climacteric, and the diseases 
which occur during this period are of a severe and fatal 
character. The table of Quetelet illustrates the liability to 
disease in those advanced in years : 

♦Smith on Consumption, pp. 200, 203. 



15 



AOB. 


Deaths in 10,000 


PbOBABLK DtTBA- 
TION OF LlFK. 

Yeaus. 


Pbobability ow 
Death. 


30 
45 
50 
60 


61 

69 

80 

114 


34.78 
27.16 
19.73 
12.83 


0,0106 
0.0135 
0.0182 
0.0330* 



Residents of cold and changeable climates are subjected 
to great and sudden atmospheric changes, deprived of sun- 
light, fresh air, sufficient exercise, and are daily poisoned by 
heaters, the elements resulting from the combustion of coal 
gas and impure air from sewers. It is an undisputed fact 
that the winter months in cold, and more particularly 
changeable climates, are especially dangerous to persona 
between fifty and seventy years of age. The old Romans 
had this pregnant expression : " Inimicus senihus hiems " — ■ 
winter the foe of the aged. In discussing the action of cold 
on the system, Dr. Osgood, of Boston, no mean authority, 
remarks : " But while the internal heat is economized, the 
heart and blood vessels are exposed to serious dangers 
which are due to high pressure. If the heart be weak, the 
sudden call upon it for more vigorous action may paralyze 
it ; the danger especially applies to the aged, to whom, 
besides, the blood vessels are liable to be weak and brittle. 
When, therofore, cold weather comes on abruptly, sudden 
deaths among the fragile and aged are common, the cause 
being apoplexy, or arrest of the heart, perhaps congestion 
of the lungs. Another evil effect of sudden cold, or e\en 
chill, is checking pei'spiration. The result may be pneu- 
monia, pleurisy, bronchitis, rheumatism or kidney trouble, 
with their train of dangerous and too often mortal after- 
effects." f 

In treating of temperature as a cause of disease, Wagner, 
p. ()0, remarks : "As regards the nature of disease, we can 
say with accuracy that the respiratory organs suffer more in 
winter and spring than in summer." The able writer on 
Consumption and Climate, Dr. Bennett, states : " Accord- 
ing to the Register General's Reports of the British Isles, 
and the mortality register all over the world, the healthiest 
winters are those that have the highest temperatures. The 
years of greatest mortality are those in which extremes of 
cold in the winter are reached. In temperate climates the 
deadliest seasons are those of greatest cold. Extreme heat 

♦Wagner's Pathology, 1877, p. 45. 

t Winter and its Dangers, H- Oagood, M. D., 1879, pp. 13, 14. , 



16 

and extreme cold not only interfere with the equilibrium of 
functional activity, throwing a strain on some of the vital 
functions of animal life to their serious risk and danger, but 
necessitates modes of existence detrimental to the healthy 
performance of these functions. Thus in very cold climates 
such as St. Moritz, in the Engandine, and St. Paul, in Min- 
nesota, United States, which have been recommended of 
late for phthisis in winter as well as summer, invalids have 
to live in winter for by far the greater part of the twenty- 
four hours in badly ventilated rooms. When they go out 
they have to undergo the transition to a temperature thirty 
or forty, or even more degrees, less than that in which they 
live during the greater part of the twenty-four hours. Such 
confinement, such transitions, even much less marked ones, 
constantly give rise in all Northern countries in winter, to 
inflammatory a flections of the mucous membranes of the air 
passages, to pneumonia and to pleurisy, and that in the 
healthiest members of the community. If it is so with the 
healthy, how can we expect those to resist such influences 
who are already diseased, who have morbid deposits, inflam- 
matory, catarrhal, scrofulous, tubercular in their lungs, 
softened or not ? How can those who have already local 
pneumonias, local pleurisies, expect to withstand their per- 
nicious influences ? Moreover, they do not live in the pure 
air they ascended to reach, but in an atmosphere vitiated 
by stove heating, by their own respiration, and by that of 
their companions."* 

Dr. Day, an English physician, calculating from about 
55,000 persons over 60 years of age, determined that the 
deaths in January were nearly twice as great as in July. 
This statement confirms the opinion of another distinguished 
statistician, " That waves of heat are waves of life, and 
waves of cold are waves of death." With these and a hun- 
dred similar warnings before us, remarks Dr. Brinton, " we 
are safe in saying that in many cases, entire relaxation from 
business, and two or three winters in a warm climate, about 
the age of sixty will add years to life." The importance of 
escaping the rigors and dangers of a Northern climate is 
being appreciated by the aged as is evidenced by the thou- 
sands of persona who annually visit Florida. In my winter 
visits to this State from 1865 to 1875, I found the majority 
of the visitors to be invalids, tourists and sportsmen, but 
my observations during the past and several preceding win- 

* Treatise on Pulmonary Consumption, J. H. Bennett, M, D., 
1879, p. 70. 



17 

ters establish the fact that the majority who visit this State 
are advanced in years and migrate with the birds to a land 
where 

"The gentle wind, sweet and passionate wooer, 
Kisses the blushing leaf." 

Climacteric delay is obviously the concatenated pheno^ 
mena arising from that exhaustion of the vital energies 
which takes place at a more or less advanced age, in conse- 
quence of the cares, turmoils and physical exertions 
dependent on existing states of society, particularly among 
the middle classes. The exhaustion manifesting itself 
especially in the functions which are most intimately related 
to and concerned in the perpetuation of the vital endow- 
ment of the frame. As this decay of the vital energies — 
this breaking up of the constitution, as it is commonly found, 
is necessarily experienced by the whole frame, it is obvious 
that it may not only be hastened by whatever is either men- 
tally or corporeally injurious, as well as specific forms of 
disease, but that it will be more or less remarkably evinced 
in those organs which have especiallv suffered during pre- 
vious attacks of disease. Hence the complicated states in 
which senile decay is usually observed, and the rapid pro- 
gress and unfavorable issue of such maladies appearing 
about the climacteric period. To obviate the occurrence of 
disease at this period of life, a change from a cold, moist 
and changeable climate, to a dry and temperate one, will 
prove advantageous. Dr. Madden remarks that " in some 
of the diseases peculiar to advanced age, change of climate 
will be the best adjuvant to husband out life's taper to its 
close." 

The word climate in its common signification indicates a 
region bounded by certain arbitrary lines, but in medicine 
it possesses a wider meaning. The effect of climate upon 
the human system is the sum of the influences which are 
connected with many factors. The climate of any locality, 
professionally speaking, depends upon its temperature, 
atmospheric vicissitudes, prt vailing winds, humidity, its 
elevation above the sea level, its proximity to the ocean or 
oceanic currents, its contiguity to mountains, lakes, rivers, 
arid areas, soil, drainage, vegetable productions, malaria, 
general sanitation and other factors, which we shall briefly 
consider. 

In his investigations. Dr. Jones overlooked Kussia, where 
the " Ice King is " in all his majesty and strength, or else 
he would have referred to the following figures : In Russia, 



from 1857 to 1859, the general mortality from phthisis was 
164 in the 1,000. In the most northern provinces, that of 
Archangel, the mortalit}' was 190 in 1,000, and in Wologda, 
204 per 1,000.* " In St. Petersburg it is very common." f 

At p. 274, Dr. Jones asserts that "North Sweden and 
Norway are likewise almost exempt from a disease [phthi- 
sis], which carries off one- tenth of the population of the 
tropics." According to the eminent authority, Dr. Lom- 
bard,! the mortality from phthisis in the northern towns of 
Sweden is 147 in a thousand ; in those in the center, 125, 
and in those in the south, 131. Norway presents the same 
high mortality from phthisis, 130 in 1,000. In Denmark 
the mortality from phthisis is 122 per 1,000, nearly the same 
as in Loudon, where it is 121. At p. 274, Dr. Jones states 
that phthisis " carries off one-tenth of the population in the 
tropics." If we are to accept this statement as fact and the ; 
figures of the eminent Dr. Lombard as reliable. Dr. Jones 
"is out of his latitude."§ 

In the language of Dr. Copeland : " As to the climate of 
different countries, and as to the influence of situation and 
locality, either in favoring or in preventing the prevalence 
of phthisis, our knowledge is altogether imperfect. Much 
that has been asserted on this subject is more or less inac- 
curate, ihe inaccuracy being often in proportion to the 
dogmatism with which the matter is treated." 

Temperature is an important factor in climate, and a very 
large proportion of the profession, who have made a special 
study of pulmonary diseases, advocate a dry, sunny and 
tern por ate climate for their successful treatment. In view: 
of the great dissemination of phthisis throughout all zones, . 
and the marked percentage of mortality ("nearly two- 
sevenths of all deaths resulting from this disease"), it is ex- 
ceedingly important that correct opinions should prevail 
with regard to its treatment. The importance of laboring 
to check this disease and limit its mortality, is an urgent 

* Bennett, Puhnonary Consumption, pp. 116 117. 

tHoaner's Oeul. Pathology, New York, 1877, p. 72. 

JTraite de Cliinatologia, vol. 2, p. 110. 

§ At p. 27+, Dr. Jones rejiarks, when discussing the infrequency 
of consumption in cold climates : "That it has lately been shown 
that the farther we progress north, the greater immunity the inhabi- 
tants enjoy from consumption." The writer uses the word "lately," 
and all his evidence can be found in Copeland's Medical Dictionary, 
published in 18.")8. In fact, in many cases the language is copied. If 
the gentleaien had made quotations from Lombard and Bennett whose 
works have been " lately " published, his position would have been 
untenable. 



19 

necessity, more especially, when there is a growing demand 
for more attention to the preservation of health, and when 
the conviction is gaining ground that this is an important 
function of medical science. 

The modern professional view that a temperate, dry and 
sunny clime is best adapted to the treatment of a large pro- 
portion of pulmonary diseases, is one of the most valuable 
contributions that modern science has made in the treat- 
ment of such diseases. It may be stated as a general rule, 
that pulmonary diseases are more frequent in cold and 
change ible climates than in those that are moderately warm 
and dry. The climatological distribution of pulmonary dis- 
eases in the United States, is illustrated by the following 
table from Blodgett's Climatology : 



Maine 

New BCampshire 

Vermont 

Massachusetts.... 

Connecticut 

Rliode Island 

New York 

New Jersey 

Pennsylvania 

Delaware 

Maryland 

Virginia 

North Carolina.. 
Soutii Carolina.. 

Georgia 

Florida 



Deaths by 
phthisis. 



1,702 
&24 
751 

3,426 
968 
470 

7,890 
915 

3,520 
118 

1,101 

1,616 

.562 

269 

279 

43 



Per cent, of ^.^^^^'^^'^y 
entire nior- <^'«''^«^ "^ « 
taiity. 



22.4 

21.84 

24.09 

17.65 

16.75 

20.92 

17.04 

14.15 

12.33 

9.76 

11.44 

8.4S 

6.83 

3.34 

2.80 

4.61 



spiratory or- 



2,074 
1,092 

^84 
4,418 
1,2.S0 

572 

10,846 

1,176 

4,621 

J 85 
1,679 
3,540 
1,688 
l,3t3 
1,334 

108 



Percent, of 
entire mor- 
tality. 



27.35 
25.82 
28.24: 
22.77 
22.31 
25.52 
23.42 
18.19 
16.80 
15.30 
17.34 
18.56 
16.60 
16.69 
13.44 
11.60 



The above figures do not properly represent the mortality 
from phthisis originating in this State, for they do not indi- 
cate the number of deaths occurring among invalids who 
came to the State in the last and incurable stages of phthisis. 
" From the United States census tables and other statistics, 
the fact is developed that phthisis in the United States pro- 
gressively decreases from Maine to Florida. Dr. Lawson, 
Surgeon-Genei'al United States Army, sets down the mor- 
tality from tubercular consumption as three times greater 
in the Northern than in the Southern States."* To illus- 



* Aitkin's Practice of Medicine, 'Vol. 2, p. 788. 



20 

trate the frequency of phthisis in the United States Army, 
at a few stations, from 1810, to 1859, inclusive, we will 
quote the following figures : 

Coast of New England 4.6 

Harbor of New York 5.6 

Great Lakes '. 4.6 

Middle Interior, West 3.7 

South Atlantic 7.9 

South Interior, East 6.9 

California, Southern 4.9 

California, Northern 5.4 

Atlantic Coast of Florida 2.7 

To illustrate the frequency of pulmonary diseases in the 
United States Army, at a few stations, we shall quote from 
Dr. Brinton's work, p. 128. The relative frequency of 
phthisis, bronchitis, pneumonia and pleurisy (omitting frac- 
tions) was as follows. One man came under the surgeon's 
care, for one or other of these diseases : 

In Arkansas, one in 16 

In Texas, southern frontier, one in , 16 

In Baton Rouge, La , one in 17 

In St. Paul, Minn., one in 19 

Id Florida, eastern coast, one in 37 

To illustrate one important factor of climate — tempera- 
ture — I shall quote from the official records of the Signal 
Service of the United States Army for the months of Novem- 
ber, December, January, February and March, regarding 
the temperature at certain points, recommended as health 
resorts. We shall confine ourselves to a great extent to 
official records, as far as the United States are concerned, 
for in some instances private observers are not educationally 
qualified ; in some cases it is questionable if their instru- 
ments are reliable, and it is possible that, at some points, 
instruments may be placed in positions where favorable 
conditions can be secured : 



21 



Cannes, Mediterra- 
nean 

Nice, Mediterranean 

Mentone, Mediter- 
ranean 

Nervi, Mediterra'n.. 

Nassau, N. P 

Atlantic City, N. J. 

Augusta, Northern 
Ga 

Breckenridge, Minn 

Dulutti, Minn 

St. Paul, Minn 

Key West, Fla 

Punta Rassa, Fla... 

Jacksonville, Fla... 

Aikin, S. C 

Los Angeles, Cal ... 















to 


i 


a 

125 


1 

a 


3 
g 


s 

i 


1 


sa 


3 


54.6° 


48.8° 


48.5° 


49.4° 


52.8° 


50.8° 


3 


53.8 


48.5 


47.0 


48.4 


51.8 


49.9 


3 


55.2 


50.5 


48.8 


50.4 


53.4 


51.6 


3 


55.2 


47.8 


46.2 


47.8 


49.0 


49.2 


1 


75.7 


72.3 


72.2 


71.9 


74.4 


73.3 


4 


45.3 


35.3 


32.2 


33.2 


37.1 


36.6 


4 


54.9 


47.6 


48.1 


49.6 


57. 


51.4 


5 


17.3 


13.4 


6.8 


13.1 


18.9 


13.9 


4 


28.8 


21.6 


12.4 


19.2 


25.7 


21.5 


5 


28.3 


20.0 


13.0 


19.4 


27.6 


21.7 


5 


74.5 


70.5 


70.5 


71.7 


73.8 


72.2 


5 


69.7 


64.8 


65.5 


65.9 


69.8 


67.1 


4 


62.1 


55.8 


56.2 


56.9 


62.7 


58.7 


5 


54.7 


46.7 


46.4 


47.5 


56.4 


50.3 


1 


62.1 


55.3 


54.1 


54.6 


55.8 


56.3 



An examination of the Signal Service Reports shows that 
in St. Paul, for the five cold months for five years, that the 
minimum temperature was 10 deg. and below on an average 
of fifty-seven days in each year. In a climate with such a 
low range of temperature for weeks together, patients suf- 
fering from, pulmonary diseases cannot take exercise in 
the open air, but must of necessity remain in artificially- 
heated rooms. Farther comment on such climatic treatment 
of pulmonary invalids is unnecessary. Why send a patient 
from a place like Boston, Massachusetts, with a cold and dry 
winter climate, to Minnesota, with its almost arctic cold, 
sudden and great vacillations of temperature and a higher 
mean relative humidity? Instead of sending patients to 
hyperborean regions, it appears to us more rational to con- 
sign them to localities possessing a moderate temperature, 
where there is sunshine, and where fresh air, uncon- 
taminated by human exhalations or other noxious effluvia, 
may be breathed, and where the quiet of Nature, the bloom- 
ing of flowers, the singing of birds, the babbling of brooks, 
will often produce marvelous improvement of health. 

t The Riviera, by E. T. Sparks, M. D. 

j Compiled from Records of Mil. Hosp., by G. A. Osborn, Esq., 
for Author. 
§ Signal Service Reports. 
II W. H. Geddings, M. D., Aiken, S. C. 



It is a remarkable fact that professional men refer a large 
proportion of cases of pulmonary diseases they are called to 
treat during the cold months, to " cold " and " vacillations 
of temperature." Yet in the face of these daily expressed 
opinions, some few consign their patients suffering from 
these diseases to moist, cold and changeable climates for 
their relief or cure. Dr. James H. Bennett, p. 70, says : 
•'' The seasons of least mortality in the year, are those in 
which the temperature is neither extreme in one sense nor 
in the other, conversely, the seasons of greatest mortality 
are those in which extremes of cold in the winter and heat 
in the summer are reached. In temperate climates the 
deadliest seasons are those of greatest cold." Dr. G. Wil- 
son (Health, and Healthy Homes, Philadelphia, 1880,) re- 
marks, " Foremost among the uncontrollable causes of 
disease, are atmospheric changes dependent upon seasonal 
variations. For example, a sudden fall of temperature is 
sure to be followed by a long train of ailments, such as 
catarrh, influenza, bronchitis, and other forms of lung 
diseases." 

Until a recent period a warm, moist and sedative climate 
was advocated for the treatment of phthisis, but since med- 
ical doctrines have changed, and the leading minds in the 
profession advocate the importance of a dry, temperate and 
bracing climate — since " Vitalistic and sthenic views of treat- 
ment prevail, and are found to give infinitely more satisfac- 
tory results than those that followed antiphlogistic treat- 
ment, the medical mind in America and in Europe, looks 
about for a cold climate. As usual, the pendulum has a 
tendency to the other extreme — to go from a tropical cli- 
mate to the ice-covered summits of the Swiss mountains, to 
the frozen plains of Northern America. Many minds can 
never constitutionally follow the golden adage. Medio lutissi- 
mus ibis. They cannot remain in the middle of the road, 
they must pass from one extreme to the other." — Bennett. ; 

Dr. Jones, of St. Paul, Minnesota, in his " Plea for Cold 
Climates in. the Treatment of Pulmonary Consumption," 
uses the following language : " When we begin to enquire 
into the character and comparative merits of cHmate, we 
are at once struck with the fallacy of the doctrine which has 
obtained for generations, that the disease is more frequent 
in cold than in warm climates. Ju.st the reverse of this is 
true. From an extensive series of data, it has lately been 
shown that the farther we progress North, the greater the 
immunity the inhabitants enjoy from consumption. It is 
well known that far up in the North where the Ice King is, 



23 

consumption is either extremely rare or altopfether unknown. 
In the bleakest, coldest and the most exposed portions of 
the globe, where winter well-nigh continuously exists, and 
where sudden and severe changes of the atmosphere hold 
to a maximum, consumption is very infrtquent. Indeed, 
so true is this, that we are forced to the conclusion that 
extreme cold is inimical to the production of consumption." 
To prove that this statement does not apply to the United 
States, we will quote from Aitkin's Practice of Medicine, 
vol. 2, p. 788 : " From the United States census tables and 
other statistics, the fact is developed that phthisis in the 
United States gradually decreases from North to South. It 
originates far less commonly in the southern than in the 
northern regions ; it gradually but perceptibly diminishes 
from Maine to Florida. Dr. Lawson [Surgeon-General 
United States Army] sets down the mortality from tuber- 
cular consumption as three times greater in the Northex'n 
than in the Southern States." 

At page 284, Dr. Jones lays down the following proposi- 
tion : " The most unfavorable climate possible for the con- 
sumptive patient is one of uniform high temperature." If 
these yiews regarding a " high temperature " and the " Ice 
King" are correct, Dr Jones should recommend patients to 
avoid Minnesota during the warm months, and seek a region 
where the " Ice King isJ' 

Under existing circumstances it is difficult, if not impossi- 
ble, to ari'ive at any positive opinion regarding the preva- 
lence of phthisis in any zone or altitude ; even at the best, 
an approximation to the truth is all we can expect. In 
forming an opinion of the adaptability of any climate for 
the treatment of phthisis we should consider climatic fac- 
tors, weigh well the mortality from phthisis, ascertain the 
efifects of climate upon invalids who have resided there for 
years, and obtain the views of experienced and intelligent 
physicians resident in such climate. 

In advocating the advantages of this or that climate or 
altitude, writers overlook the influence of food, the immu- 
nity from phthisis in some races ; the prevalence of phthisis 
in the Caucasian race, and the crosses of this race with the 
negro and other dark races. The lensrth of time the locality 
has been settled, the crowding of persons in towns and 
cities, habits and occupations of residents, and numerous 
other important points in the etiology of phthisis. Dr. Rush 
remarks (Med. Enquiries, vol. 1, p. 37), that "pulmonary 
consumption is unknown among the Indians in North 
America." As the Indians inhabited each State in th© 



24 



Union, we might use it as an argument to prove that high 
or low altitudes are favorable for the climatic cure of phthisis. 
Such a line of argument would appear ridiculous ; yet 
writers of to-day use such arguments to establish their theo- 
ries. In support of this thecry that phthisis is more preva- 
lent in warm than cold climates, Dr. Jones makes the 
following statement : "In Nova Scotia and New Bruns- 
wick, where the temperature is very low, the disease is less 
frequent than in Jamaica," and cites the British army 
reports as authority. To illustrate how much dependence 
there is to be placed in this statement, we shall quote from 
the tables of Dr. G. T. Balfour, compiled from the Reports 
of the British War Office, with regard to the admissions and 
deaths from tubercular disease among British troops per 
one thousand mean strength at a few points : 



Nova Scotia, 
Etc. 


Jamaica. 


Great Brit- 
ain. 


Madras. 


Bombay. 


§ 




a 
.2 

a 

-a 
•< 




.9 

00 
OQ 

B 




CD 

a 
.2 

GQ 

a 


CO 

a 


GD 

a 

.2 

'So 

GO 

£ 
< 




14. 


2 29 


5. 


1.96 


19. 


3.48 


16. 


1.88 


9 


1.53 



One argument advanced by a few physicians in favor of 
cold climates as a winter resort for invalids, is the fact that 
the respiratory process is more perfectly performed in cold 
than in a warm climate. This doctrine may apply to per- 
sons who are able to resist the influences of cold ; but the 
question arises, how many invalids who are suffering from 
pulmonary disease can safely use this climatic remedy? 
A large majority are injuriously affected by a low tempera- 
ture and great and sudden thermal changes, and remain 
indoors in heated rooms, and take no exercise in the open 
air, unless the thermometer rises to 40, or above, and the 
very object for which they visit a " cold and invigorating 
climate " is defeated. Exercise increases respiration, appe- 
tite, innervation and assimilation, and it can only be safely 
and regularly taken where there is a dry atmosphere and a 
favorable thermometric i-ange. If the temperature is not 
too high or too low, patients can enjoy sunlight and fresh 
air, and take exercise out of doors without incurring the 
risk of inducing pneumonia, pleurisy or bronchitis. Oppor- 
tunity to take daily exercise in the open air is a matter of 
vital importance to the invalid, and a climate should be 



25 

selected where this can be accomplished. • To illustrate the 
influence of exercise in increasing the respiratory process, 
we shall quote from the excellent work on phthisis by Dr. 
Smith, ot the Brompton Consumption Hospital, London. 
Dr. Smith's data are based on a large number of experi- 
ments upon the various kinds of exertion over the quantity 
of air expired, and from these we learn that taking the 
quantity of air inspired when lying and at rest as unity, the 
effect of ordinary exertion is as follows : 

" Table showing the influence of exertion over the quan- 
tity of air inpired : 

1. Lying 1.0 

2. Sitting 1,18 

3. Standing 1.33 

4. Singing and reading aloud 1.26 

5. Walking at one mile per hour 1.9 

6. Walking at two miles per hour 2.76 

7. Walking at three miles per hour 3.22 

8. Walking al four miles per hour 5.0 

9. Horse exercise, walking 2.2 

10. Cantering 3.16 

11. Trotting 4.06" 

The effect of the respiratory power is modified by the 
degree of the purity of the air. It has been abundantly 
proved by de Saussure, Falkland and Welsh, that the com- 
position of the air at the highest attainable altitudes is 
identically the same with that found at the level of the low 
lands, but at lower levels there may be great diversity in the 
constitution of the air as the result of defective sanitation, 
or in badly ventilated apartments. In this connection we 
cannot refrain from referring to the published statements 
regarding the purity of the air of elevated sections. Such 
statements are merely calculated to mislead those who are 
ignorant of the facts in the case, for pure air can be obtained 
in temperate climates without ascending mountains. It has 
been asserted that at high elevations the respirations are 
quickened, and, as a consicquence, the patient is benefited. 
It appears proved by the researches of M. Coindet, a French 
physician, in his Medical Letters on Mexico, that although 
the respirations are increased in number, less air is inhaled 
than in lower localities. M. Jourdanet, who practiced many 
years in Mexico, at an elevation of seven thousand feet, 
claims that it is detrimental to human health and life, 
bringing on amaemia, which he calls Barometrical anoxy- 
aemia, the result of deficient oxygenation of the blood. M. 
Lombard, asserts that plethora and the inflammatory dia- 
thesis characterizes the pathology of medium alpine climates, 



26 

but recognizes anaemia in the higher regions from this 
cause. 

Elevated localities have been recommended for phthisical 
fcases, and the recommenders forget that the air is rarefied, 
and that the amount of oxygen inhaled is much less than at a 
loiver level. One of the strongest advocates of elevated dis- 
tricts, Dr. Denison, of Denver, Colorado, says: "Then, 
aside from the susceptibility of the nervous system, the 
character and acuteness of the diseased conditions of the 
lungs, defective vital force, etc., the acclimatization is rapid 
and easy, or prolonged and uncertain, nearly in propoi-tion 
to the amount of lung tissue involved — advanced age being 
usually considered an unfavorably modifier. This general 
statement makes the accimatization of individuals an accom- 
jilished fact after a reisidence of from two weeks to two. or 
even four months, at the end of ivhich period a somewhat accu- 
rate estimate can be made of the efifect. to be expected from a 
prolonged residence in this elevated region."* From Dr. 
Denison's statements, it is evident that persons advanced in 
years, or whose lungs are seriously diseased, should not 
visit Colorado. If it requires from "two weeks to four 
months" before a patient can become acclimated at our 
Western mountain resorts, it appears like a dangerous pro- 
ceeding to make the experiment. Two weeks, or four 
months, are all-important periods of time in the existence 
of persons suffering from pulmonary diseases. Such cases 
are not suitable ones for experiments in acclimatization ; 
and patients should select a climate where such experiments 
are unnecessary. 

In cold climates range of temperature, cold winds, snow, 
and bad walking interfere with the taking of suitable exer- 
cise, and innervation, nutrition and assimulation are inter- 
fered with to the injury of the invalid. A high range of 
the thermometer is objectionable in the treatment of pul- 
monary diseases, for in hot climates the number of respira- 
tion are diminished. The effect' of the lessened number 
of respirations is to reduce the total respiratory action 
considerably. Rathryhas shown that the average amount ia 
in the temperate zone (temp. 54 deg. Fahr.) 239.91 cubic 
inches per minute, while in the tropics (82 deg. Fahr.) only 
195.69 cubic inches were inspired, so that there is a differ- 
ence of 38.65 cubic feet in 24 hours, or 18.43 per cent, in 
favor of a temperate climate. If 10 ounces of carbon are 

♦Rockv Mountain Health Resorts, 0. Denison, A. M., M. D., Bos- 
ton, 18b0i p. 147. 



a? 

expired in the temperate zone, only 8.157 ounces would be 
expired in the tropics. A high thermal range, more 
especially if associated with a moist atmosphere, interferes 
with physical exertion, and in this respect is injurious. 
Hence a climate like that of Nassau or Cuba is objectionable 
as a resort for pulmonary invalids, as the high range of 
temperature interferes with the respiratory function and the 
taking of exercise. From personal observation and a care- 
ful study of the subject in all its bearings, we feel assured 
that the most suitable winter resort for the invalid, as a 
general rule, is one possessing a moderate temperature, 
plenty of sunshine, a dry atmosphere, with opportunities to 
take daily exercise and inhale the pure air of Heaven. 
When referring to the action of hot and cold climates on 
consumptive patients. Dr. Fuller, Physician to St. George's 
Hospital, London, remarks : " Their organization is deli- 
cate, their constitutions weak, their extremities are often 
cold, they are pinched and prostrated by a low temperature, 
and they are susceptible of damp. To such persons a warm 
atmosphere is invigorating in the highest degree, and with- 
out its aid, medicine and the most carefully regulated diet 
are of little avail."* When referring to the evils of the 
winter season. Dr. Smith remarks : " The evils of the 
season will, however, be the tendency to internal congestions 
and inflammation, the increase of cough from the irritation 
of the pharynx and air passages, induced by the inhalation 
of cold air, the tendency to haemoptysis from increased 
cough, irritability of the mucous membrane and congestion 
of the lungs, and deficiency of temperature from the cold. 
If the patient be restricted to an artificially heated atmos- 
phere, he will have the evils of dryness, stillness and 
impurity of the air, and will be apt to have night sweats 
from excess of clothing. "f 

I fully concede with Dr. Wilson (Health and Health Ke- 
sorts, p. 26), that as a summer resort for phthisical patients, 
and " overworked nervous system, and prostrated physical 
frames, our Northwestern States of Minnesota, Wisconsin, 
Colorado, Nevada and Idaho, with their clear, bracing and 
tonic atmosphere, will bear a favorable comparison with 
either the Alps, Appenines or Pyrenees ; yet it is my hum- 
ble opinion that no section east of the Rocky Mountains 
presents so many thermometric attractions and climatic 
advantages for the invalid in the winter as Florida. If the 



* Fuller on the Lungs, 1867, p. 434. 
t Smith on Cousuiuptipn, 1865, p. 200. 



28 

patient requires a dry, bracing and temperate climate, it 
can be found in this State ; if s,ea air with its concomitant 
harshness is indicated it can be secured ; if an interior 
climate is desirable it can be found ; if a given case 
demands a warm and comparatively moist climate it is acces- 
sible. Owing to the facilities and comforts for traveling, 
and the equable temperature, a change can be rapidly and 
safely made from place to place. When referring to the 
adaptability of the climate of Florida to the treatment of 
pulmonary diseases. Prof. Lee, of Geneva Medical College, 
remarJcb : " We have already spoken of the mildness of the 
climate of this region of the United States. It appears to 
possess an insular climate not less equable and salubrious 
in winter, than that afiforded by the South of Europe, and 
is, therefore, well adapted to the forms of pulmonary dis- 
ease, as bronchitis and incipient phthisis as are benefited by 
a mild climate. Mildness and uniformity are the two dis- 
tinguishing characteristics of the climate of the Florida 
peninsula. It is easily demonstrated, that invalids requiring 
a mild winter residence, have gone to foreign lands in search 
of what might have been found at home, an evergreen land, 
in which wild flowers never cease to unfold their petals."* 

The therapeutic importance of sunshine as an element in 
the treatment of disease, is unfortunately too little appre- 
ciated by invalids. "Lombard tells us that light stimulantes 
and darkness impedes respiration, and through respiration, 
of course, animal heat and muscular activity. Moleschott 
proved this fact by experiments upon himself, and the scien- 
tists, Bidder and Schmidt, noticing that animals at rest 
produced more carbonic acid in daytime than at night, 
equalized ibe amount by depriving them of the influence of 
light." An Emperor once went to Diogenes as he was 
reclining in his tub, and inquired what he could do for him. 
Diogenes replied : " Stand out of my sunshine." And when 
a physician advises a patient to spend a winter in a cold and 
changeable climate, the latter should exclaim, with Diogenes, 
"Sttind out of my sunshine." Sunlight, in the language of 
Dr. Chambers, of St. Mary's Hospital, " is of importance to 
the inviilid." And the invalid should remember the Italian 
proverb : " Where the sun does not enter, the doctor must." 
Dr. Maddon, who has made a special study of pulmonary 
diseases and climatic influences in their treatment, states : 
" That preference should always be given to those winter 
resorts which present the greatest inducements and oppor- 

* Copelaad's Dictionary of Medicine, vol. 1, p. 416. 



29 

tunities for open-air exercise, and no small part of the benefit 
desirable from removal to a Southern health resort results 
from the opportunities afforded in the latter of deing much 
in the open air, instead of being cooped up within doors, as 
the patient would be during the greater part of the winter 
had he remained at home." * 

Dr. Osgood, of Boston, no mean authority, remarks : 
"During the winter season we need every health-giving 
influence. Deprived of sunshine, we are less able to meet 
the stringent stresses of cold weather. Anything which 
lessens animal vigor, lessens also our ability to cope with 
the great changes in temperature, and the imperfect hygienic 
conditions to which winter exposes us. What sunshine is 
able to do for all life, may be seen in the joy of the birds, 
and increased activity of animals, and the greater Vivacity 
and cheer which we feel when the sunshine returns to us, 
after days of absence behind the clouds. How we miss it 
when it is gone. How its absence (it prolonged) depresses 
us ! Should we not learn the lesson and insist upon every 
ray of sunshine? Life in sunless rooms not only injures 
the bodily health, but most seriously depresses the mind. 
Above all, sunshine should be given to the sick. The progress 
of the illness, and the effects of remedies will then be a 
thousand fold more favorable."f And I will ask you, if 
invalids can secure the health-giving influences of sunshine 
and out-door exercise in a climate where the thermometer 
ofttimes approaches zero, and snow storms, fogs and cutting 
winds confine him to an artificially heated room ? Persons 
suffering from disease require sunshine, a moderate tem- 
perature, plenty of fresh and pure air, and an opportunity 
to take out-door exercise ; and where east of the Rocky 
Mountains, during the cold months, but in the "balmy 
South," can these conditions be secured? Dr. Denison, p. 
59, remarks : " The conclusion of our thermometrical 
observations is well expressed by Dr. Schreiber, that pul- 
monary consumption is neither favored by a low tempera- 
ture, nor prevented, nor cured by a high one." Although 
an advocate for elevated climates, Dr. D. unconsciously sup- 
ports our position that a temperate climate, is the climate 
par excellence for the invalid. 

Dr. Osgood remarks : " The objection to our climate 
(Northern States) is that its sudden changes from heat to 
cold, from dryness to chilly dampness, are deadly in their 

♦Health Reports, p. 7. 

t Winter and its Dangers, Dr. Osgood, p. 121. 



30 

effects upon the exquisitely sensitive blood vessels of the 
mucous membrane of the lungs." If sudden and great 
atmospheric changes are productive of disease in healthy 
persons (and this is universally admitted), it is to be pre- 
sumed that such conditions will injuriously affect the invalid. 
Extremes of cold and heat, are not conducive to longevity 
or health, and in this, as in everything else, we may say with 
the poet : " Medio tutissivius ibis." The mean temperature 
of a health resort is of much less importance than the 
rapidity and frequency of transitions between the highest 
and lowest temperature, and preference should always be 
given (other things being equal) to that climate which pos- 
sesses the most equable rather than the warmest climate."* 
As thermometric range is a matter of great importance in 
the causation and treatment of disease, more especially pul- 
monary affections, we will give the ranges for the cold 
months at a few points, recommended as winter resorts : 



Atlantic City, N. J... 

Augusta, Ga 

Minnesota, 3 stations. 

Florida, 3 stations 

Colorado, :i stations. .. 
Los Angeles, Cal 





» 


M 




(H 






m 




\x 


» 






m 


P5 


K 


<1 




CO 


S 


s 


■«1 


t= 


W 


K 


H 


w 


P 


« 




< 


> 


o 


K 


P5 




H 


O 




<i 


H 




>i 


^ 


M 


•-S 


\^ 


S 


4 


45 


48 


48 


48 


46 


4 


49 


49 


51 


48 


50 


4 


70 


63 


57 


58 


58 


4 


35 


37 


35 


33 


35 


4&2 


68 


70 


72 


58 


63 


1 


41 


44 


35 


30 


35 






47 
49 
61 
35 
67 
37 



To illustrate thermal ranges for one year, we shall quote 
from the work of Dr. Denison, and add ranges for Florida 
obtained from Signal Service Reports for corresponding 
period : 





Mean 

Monthly 

Range. 


Range of 
Monthly 

Means. 






Atlantic City, N. J 


41 

44 

53 

61.5 

60.5 

63.5 

29.7 


44.1 

40.7 
57.4 
48.9 
53.7 
47.7 
19.2 


49.7 
57.3 
54.2 
43.6 
49.2 
46.8 
73.4 


89.5 


Norfolk. Va 


89.5 


St. Louis, Missouri 


117 


Clieyenne, Wyo 


136 


Denver, Colorado 


131 


Colorado Springs 


123 


Florida Peninsula ; 


50 



♦ Madden, Health Resorts, p. 3. 



The winter range at Atlantic City is comparatively Tow 
for a cold climate, but this advantage is counterbalanced by 
the low temperature and the high mean relative humidity. 
Aikin, S. C, has been lauded as a winter resort for con- 
sumptives, and as we have been unable to secure official 
data regarding its thermal range, we have given the figures 
of Augusta, Georgia. As the points are not far distant, we 
have reason to believe that the data which will apply to one 
Will apply to the other. When referring to the climate of 
Aikin, Dr. Walton, of Cincinnati, says : "We find there a 
monthly range which ensures the occurrence of frost fre- 
(^uently, and causes the invalid an infinite amount of care in 
adapting himself to these changes."* We spent the winter 
of 1844 and '45, and 1845 and '46, in Georgia, and our 
^perience led us to believe that the climate is too change- 
able for the successful treatment of pulmonary diseases. 

Wit'i regard to Aiken, S. C, we must express it as our 
(!jpinion, that it is adapted to the climatic requirements of 
invalids in October, November, May, and a portion of June ; 
but we beliv3 a more suitable climate for invalids can be 
found for the intervening months. Much attention haH 
Been directed of late to the movintain sanitarium of Dr. 
Gleitsraan, of Ashville, N. C, and we are of the opinion that 
as a spring, summer and autumn resort for invalids, it is 
tvorthy of notice and patronage. The Doctor himself is a 
highly educated physician, and eminently qualified to con- 
duct such an institution. 

' Elevation of sanitary t-esorts has attracted much attention 
of late years, and a few writers have insisted upon the im- 
portance of elevated localities as a preventive and a cure fr r 
phthisis. Some advise an elevation of 1,200 I'eet ; others 
recommend 2,500 to 3,000, and others insist upon 6,000 to 
8,000 feet. And the question arises, who is right? In sup- 
port of their views, they refer to the immunity Irom phthisis 
in the mountainous regions of Switzerland ; and at an eleva- 
tion of about 9,000 feet in the warmer portions of South 
America. But the advocates of high altitudes, have evidently 
overlooked the interesting and instructive work by Dr. Emil 
Muller, of Winterthur.f This work, from which we shall 
quote a few figures, is principally statistical, and gives 
an elaborate account of the mortality from phthisis in that 
country. 



• * Comparigon of European and American Climatic Resorts, G. Wal- 
fon,'M. D., Philadelphia, 1877. 
t Der Verbreitung der Lungenschwindsutch, in der Schweiz, 1876. 



32 

*• Average mortality from phthisis in the mountain regions 
of Switzerland : 

BLEYATION. FKET. OOOUPATION. 

^«-: I'^^O Ugricultural 6.o) 

wr^-v, 1 «nn (Industrial (10-2) 

^^ ^'''"" (Agricultural ( 5.3J 

v>T^.r^ 9 <inn (Industrial 4.7 

'rom 2,300 )^,., Q f. 



.16.1 



.22.3 



rp „„„„, Mixed 9.6>- 17.2 

To 3,000 (Agricultural 2.9j 

T3i- o AAA (Industrial 6.5) 

^2r ^'JS^>ixed 6. it 

To 3,400 ^Agricultural 3.5) 

From 3,400 jjjd"/]"*^ ?-«| 

From *'*OOUixed 7 7 

Above 6,000^ Agricultural 4.11 

These data are instructive, and negative the statement 
made of late years, that there is any special immunity from 
phthisis in the mountain regions of Switzerland. They 
show that a certain proportion of the population in the 
higher regions die as elsewhere from phthisis — the rate to 
a certain extent depending upon occupations in life. One 
of the highest factors among the industrial is 9.8 at an eleva- 
tion of from 3,400 to 4,400. At 4,400 to 5,000 feet in mixed 
labor, the death rate from phthisis is 7.7 ; and among the 
agriculturists we find the mortality above 5,000 feet to be 
greater than at some lower altitudes. 

These figures develop much of interest to the climatplo- 
gist. At high elevations in cold climates during the winter 
months, persons are confined in imperfectly ventilated 
rooms, heated by stoves. Under such circumstances, respi- 
ration is imperfectly performed, and the products of retro- 
grade changes are not perfectly eliminated — the health is 
impaired and phthisis is engendered. By living in winter 
on a Swiss mountain, or an elevated locality in the Northern 
or Northwestern States, the invalid is merely subjected to 
the climatic conditions of Archangel with a mortality from 
phthisis of 190 in 1,000, or of Wologda with a mortality of 
204 per 1,000. 



33 

Phthisis appears to be, rare in the elevated regions of 
tropical South America, and this is advanced as an argu- 
ment for sending patients to an elevated locality in Europe 
and the United States. But unfortunately for the theory, 
the climatic conditions are entirely different. In Switzer- 
land and the United States, the snow line is about eight 
thousand feet, and in tropical South America it is from 
thirteen thousand to seventeen thousand. Hence an eleva- 
tion of eight thousand feet in Europe and the United States, 
is a totally different factor to that of a similar elevation in 
South America. In the latter country, at an elevation of 
even nine thousand feet, the climate is warm in summer, and 
temperate and bracing in winter — more closely resembhng 
the climate of Florida than that of the elevated regions of 
Switzerland and the United States. 

When advocating high latitudes, and referring to the 
absence of phthisis in this locality or that one, writers make 
no reference to race or the habits and occupations of the 
population. When they refer to the inhabitants of high 
altitudes in South America, they neglect to state that their 
houses and workshops are large and open, and that they are 
not subjected to sudden and great atmospheric changes, and 
are not confined in badly ventilated apartments, and daily 
and hourly poisoned by a contaminated atmosphere, the 
result of stoves and respiration. 

Kace as well as habits has much to do with the causation 
of phthisis. One argument advanced against warm and 
temperate climates is the great mortality among the colored 
troops in the British colonies. According to Dr. Living- 
stone, phthisis is almost unknown in Africa among the 
aboriginal tribes. Yet in tropical climates the mortality 
from phthisis among the colored troops is very great ; but 
alcohol, exposure, syphilis and other factors can be made to 
account for the great mortality from this disease, in a race 
that enjoys an almost perfect immunity from it in an abo- 
riginal condition under a vertical sun. In forming an 
opinion regarding climates, many factors must be consid- 
ered, and altitude is of less importance than temperature, 
prevailing winds, dry soil, and a low mean relative hu- 
midity. 

""With regard to the temperature of the air, it is abso- 
lutely certain," says Prof. Buhl, " that it is not the mean 
temperature of a place which regulates the frequency of 
catarrh or phthisis, but only the lar-ger, sudden and oft- 
recurring vacillations of temperature, which the compensa- 
tory power of our body is unable to resist. Therefore the 



84 

temperature of the air, and its rapid vacillations must be 
reg^arded as exciting caused', of inflammatory phthisis"* At- 
mospheric changes in the North and West are sudden and 
great ; but in Florida they are infrequent and not extreme. 
At times, what ai-e called "cold snaps" occur, but their 
visits are infrequent, and they seldom last over one, two or 
three days ; and at any time the invalid can take exercise 
out of dooi's in the middle of the day. Owing to the low 
level of the land, the absence of snow and ice, and the 
warmth of the soil for a long distance to the north and 
west ot this State, and the influence of the winds from the 
Gulf, the northerly and westerly winds are modified and 
robbed of their harshness and refrigerating eff"ects before 
they reach Florida, and as a consequence they do not exert 
the same injurious influence that they do at points to the 
north and west of this State. 

In reply to my circular letter, that accomplished observer 
and meteorologist, Dr. Baldwin, who has been in practice 
in this city for over forty years, remarks : " Stormy 
weather here is comparatively rare, sustaining a proportion 
of about one storm here to ten at the North and Northwest. 
The air here is remarkable for its purity, and the tempera- 
ture renders it possible for the patients to take out-door 
exercise, so as to inspire the pure air." 

The subject of winds is a matter of importance in esti- 
mating the adaptability of any climate as a health resort. 
The prevailing winds for the five cold months in Minnesota 
are from the north, northwest, and west. A reference to 
the Signal Service Reports shows that 453 observations were 
taken during November, December, January, February and 
March, at three stations in Minnesota, and north, northwest, 
and west winds were found blowing from these points 190 
times. During the same period, and as a result of a similar 
number of observations at three stations in East Florida, 
the wind was found blowing from the east, southeast and 
northeast, 223 times. All are aware of the refrigerating 
effects of northerly and westerly winds in the North and 
"West, and that during their continuance a majority of in- 
valids must of necessity be confined to the house. The 
Apalachians interfere, to a great extent, with the course of 
northerly and westerly winds, and by the time they reach 
this favored land they are robbed of their injurious influ- 
ences. At times these winds affect the northern and west- 

* Letters on Tuberculosis, bv Dr. Buhl, Prof, of Path. Anat, at 
Munich, Zolf Briefe, 1872, p. 146. 



35 

ern portions of the State, and several times during the 
winter slight frosts may occur. During some winters the 
mercury does not reach 32 deg. Fahi ; as evidence of this, 
I need but refer to the fact that the lowest temperature in 
this locality during the past winter was 34 deg. 

Easterly winds have a bad reputation, and it is somewhat 
remaikable, that the Kev. G. Kingsley never visited Florida, 
and yet he wrote an cde to the east wind : 

" Welcome wild northeaster ! 
Shame it is to see 
Odes to every zephyr, 
Ne'er a verse to thee." 

In one section of the world, at least, easterly winds are 
not objectionable, and this is in Florida. On the Peninsula 
easterly winds are the prevailing ones in the cold months. 
During November, December, January, February and March, 
at three stations in E;ist Florida, easterly winds, east, north- 
east and southest were found blowing at 224 observations. 
Owing to the proximity of the Gulf stream, with its vast 
volume of heated water to the east of the coast, the easterly 
winds are robbed of their harsh and searching properties 
which characterize them in most localities. As an evidence 
of the influence of the Gulf stream thousands of miles from 
Florida, even after it has parted with much of its warmth, 
we need but refer to its effects in modifying the climate of 
tLe south of England and Fi-ance. However objectionable 
easterly winds may be in other sections, in this evergreen 
State they are the opposite. 

Precipitation of moisture in the form of snow and rain, 
is a subject worth consideration by the invalid. In the 
North and Northwest the presence of snow renders the 
taking of exercise a laborious and unpleasant occupation ; 
and when it melts and assumes the form of slush, walking 
entails the risk of wet feet, colds, and inflammatory affec- 
tions of the lungs. In Florida, the winter is the dry season, 
afid rains are infrequent. Owing to the character of the 
soil in a majority of places, the rain is absorbed as rapidly 
as it falls, and within a few minutes alter a shower an in- 
vnlid can walk out without incurring the danger of wetting 
the soles of his shoes. 

One of the most important factors of climate in the treat- 
ment of diseases, and more especially affections of the 
respiratory organs, is a dry climate ; and under the bare 
supposition that this or that is a dry climate, invalids are 
frequently consigned to an unsuitable locality. By some 



36 

peculiar process of reasoning, the masses have arrived at 
the couchision that all cold or elevated localities possess dry 
climates. Hence we see advertisements of sanitariums, in 
which an elevation of 200, 500 or 1,000 feet is referred to as 
an evidence of "dryness of the air." But an unprejudiced 
examination of this subject will soon dispel the illusion. To 
illustrate the subject of "dryness of air" as dependent upon 
altitude, we will append a few figures from the Signal Ser- 
vice Reports for the years 1877-1878 : 



MEAN RELATIVE HUMIDITY. 












H 
pj 


<1 






STATIONS. 


^ 


g 

f^ 




< 




^ 




5° 




S 


!> 
o 




a 


m 

M 


< 


SS 




< 


^ 


p 


1-5 


P^ 


s 


S lO 






per ct. 


per ct. 


per ct 


per ct. 


per ct. 




Boston, Mass 


142 


68.0 


61.8 


GO. 6 


68.2 


63.7 


65.6 


Mount Washing- 
















ton N H. 


6,285 
GOO 


87.9 
81.9 


78.2 
83.1 


84.7 
82.9 


76.7 
73.5 


85 . 6 
79.6 


82.6 


Alpiua, Mich 


80.2 


Savaunah. Ga 


48 


72.3 


69.4 


66 . 1 


66.8 


65.8 


68.1 


Omaha, Neb 


1,000 


73.7 


77.8 


78.6 


73.0 


66.8 


73.5 


Jacksonville, Fla.. 


22 


71.8 


70.0 


67.8 


68 . 5 


66.4 


68.8 


Yankton, Dak 


1,278 


73.3 


78.. 5 


74.1 


75.8 


63.0 


72.9 


B r t! (! k e n r i d g e , 
















Miun 


96r. 


76.9 


83.2 


76.8 


81.8 


79.5 


79.6 

' 



In Boston, Savannah, and Jacksonville, we have three 
stations at very low elevations, and singular to say, the mean 
relative humidity of these places is very low. But the most 
amusing thing in connection with this subject is the fact 
that patients are sent from Boston, Mass., to Minnesota, 
because the air of the latter State is " dry and desiccating." 
It may be refrigerating in winter, but riot "dry and desic- 
cating." Its low winter temperature, and sudden and great 
thermal changes, may be productive of inflammatory affec- 
tions of the respiratory organs, but if we are to accept the 
views of those who have made diseases of the lungs a special 
study, it is certainly unsuited to the climatic ti'eatment 
of a large majority of pulmonary diseases during the cold 
months. 

In discussing the influence of a high mean relative hu- 
midity as a cause of pulmonary disease, Sparks, p. 106, 
asserts : " That dampness of the atmosphere of a place — a 
high relative humidity, is a potent predisposing cause of 



37 

phthisis." On this point, Prof. Buhl, Zwolfter Briefe, p. 
147, remarks : " The mnjority of districts in which phthisis 
is rife, are distinguished by a high degree of atmospheric 
humidity, while on the other hand, the places where it is 
rare are remarkably dry. As a fact, a large and constant 
amoiant of dampness in the air gives rise to the phthis cal 
constitution." Dr. Sparks, one of the latest and best 
authors on the influence of climate, and the cure of phthisis 
by climate, states : " Dampness of the atmosphere of a 
particular place — a high relative humidity is a potent pre- 
disposing cause of phthisis." Dr. Madden (Health Resorts, 
p. 4) remarks : "My experience as x)hysician to three large 
institutions, have confirmed the observations in my first 
work, published several years ago, that there is no class of 
patients in whom we may more confidently hope for the 
beneficial effects of change of air than in the case of chil- 
dren predisposed to the scrofulous diathesis, or by heredi- 
tary taint to consumption. The climate chosen for the 
treatment of this predisposition to tuberculous disease, 
should be dry, braring and equable." 

By some unaccountable means, the opinion has become 
widespread that "Minnesota possesses a remarkably dry win- 
ter climate," and as a consequence patients are deceived and 
sent from a drier one An examination of the Reports of 
the Signal Service, in regard to Mean Relative Humidity in 
the United States, will establish the fact that Minnesota 
does not possess a " dry and desiccating climate " — in fact, 
Breckenridge, Minnesota, is remarkable for its humidity. 
Newspaper correspondents and some parties interested ia 
hotels and sanitariums north of Florida, and physicians who 
are ignorant of climate, have announced to the woi'ld that 
" Florida is a foggy, changeable climate, reeking with moist- 
ure," when the opposite is the fact. 

To place the subject of Mean Relative Humidity in a clear 
and unmistakable light, we shall freely use the material 
furnished by the Signal Service Reports, and not use data 
of private individuals, which are not always reliable. I will 
simply remark, that when the atmosphere is saturated with 
moisture, it is said to contain 100 per cent., when one-half 
or one-quarter saturated, 50 or 25 per cent., and whea 
absolutely dry, 0. 



38 



MEAN RELATIVE HUMIDITY. 



Mentone and 

Cannes* 

Nasau, N. Pf... 
Atlantic City, N. 

JJ 

Brecli e n r i d g e, 

Miunt 

Duluth. Minn X . 
8t. Paul, Minn t 
Punta Rassa, 

Flat 

Key West FlaJ 
Jacksonville, 

Flat 

Augusta, Ga J... 
Bismarck, Dak j 
Boston, Mass J.. 



X 

< 
w 


w 
n 
S 

> 


Deoembee 


M 
< 

t-3 


< 

n 
» 

per ct. 


o 
< 




per ct. 


per ct. 


per ct. 


per ct. 


3 

1 


71.8 
76.1 


74.2 

72.0 


72.0 
77.0 


70.7 
72.5 


73.3 
68.4 


5 


76.9 


79.1 


80.6 


77.3 


76.8 


5 
5 
5 


76.9 
74.0 
70.3 


83.2 
72.1 
73.5 


76.8 
72.7 
75.2 


81.8 
73.3 

70.7 


79.5 
71.0 
67.1 


5 
5 


72.7 
77.1 


73.2 
78.7 


74.2 
78.9 


73.7 

77.2 


69.9 
72.2 


5 
5 

1 
1 


71.9 

71.8 
76.6 
68.0 


69.3 
72.6 
76.4 

61.8 


70.2 
73.0 

77.4 
6.;. 6 


68.5 
64.7 

81.6 
68.2 


63.9 
62.8 
70.6 
63.7 



rt 00 

r S3 






ui \ ^ ir.. 



per ct. 

72.4 
73.2 

78.1 

79.6 
72.6 
71.3 

72.7 
76.8 

68.8 
68.9 
76.5 
05.6 



per ct. 



74.5 



72. 



It is nothing unusual to send patients from Boston, Mass., 
to Minnesota, because the opinion prevails that the air of 
the latter is " dry." The mean relative humidity for the 
five cold months in Boston is G5.6, and the mean for three 
stations in Minnesota is 74.3, 8.7 per cent, in favor of the 
former. Patients are advised to leave Philadelphia and 
secure the advantages of the '* dry climate of Atlantic City." 
Yet the mean for Atlantic City is 78.1, and that of Phila- 
delphia 73.9, a difference of 4.2-10 per cent, in favor of the 
latter. The public and a large majority of the medical men 
speak of Minnesota as possessing " a dry and desiccating 
climate," and Jacksonville "a moist and changeable one" — 
an " atmosphere loaded with moisture." But three stations 
in the former give a mean of 74.4, and Jacksonville 68.8, or 
5.7 in favor of Jacksonville. 

A French proverb is : " On ne meurt que de betise" (the 
common cause of death is stupidity), and it seems to be 
applicable to a portion of the profession, as far as a know- 
ledge of climate is concerned. It is the great duty of the 
profession to prevent disease, and when it arises to relieve 

" Reviera, Dr. Sparks, p. 9. 

t From Meteorological Records of Military Hospital, Nassau, N. 
P., obtained for writer by A. O. Osborn, Esq. 
X Signal Service Eeports. 



39 

it by natural and harmless remedies in preference to di UTfS. 
And I will ask you how many physicians are familiar with 
the factors of any climate, and sanitary laws ; and how many 
are competent to give a just opinion regarding the advan- 
tages or disadvantages of any given sanitarium or winter 
resort ? To use the language of a learned legislator : " The 
physician is like Nebuchadnezzar ; he dreams, and death is 
the sentence of him who cannot divine what that dream 
was." A physician situply recommends a patient to go to 
Florida, without carefully inquiring into the special condi- 
tions of the case, or determining if the patient requires a 
dry or moist climate, a bracing or relaxing one, a residence 
in the interior or on the coast, a high or moderate range of 
temperature, for all these conditions can be found in this 
State. The word " Florida " is sufficient, and the medical 
adviser is relieved of responsibility. These are matters of 
the gravest importance as affecting human life ; and the 
time has ai rived when our Medical Colleges should have a 
chair of Climatology and Hygiene, and render a knowledge 
of these subjects essential to graduation. At present, much 
ignorance preva'ls even in high places with regard to cli- 
mate ; and I will ask you what proportion of physicians who 
recommend patients to sanitariums and climatic resorts, 
can give intelligent answers regarding prevailing winds, 
diseases, temperature, thermometric range, atmospheric 
changes, water, soil, humidity and other important climatic 
factors. 

Among the factors on which the development and pro- 
gress of pulmonary diseases certainly depends, dampness of 
soil "is an important one, and merits the consideration of 
physician and patient. Every agricultural engineer is aware 
of the fact that draining soil renders it warmer and more 
healthy. Sparks, p. 106, states : " A high relative humidity, 
especially when associated with a damp soil, is a potent 
pi'edisposing cause of phthisis." Dr. Pollock, in his lectui'es 
at the Consumption Hospital, London (Med. Times, 1878), 
reraai'ked : "Low, damp and ill-drained localities are those 
where the disease is most prevalent and fatal." A wet, cold 
soil is productive of pleurisy, pneumonia, bronchitis and 
rheumatism. In analyzing the cause of 1,000 cases of 
phthisis, Dr. Williams found that "14.2 per cent, could be 
traced to inflammatory attacks of the lungs." And accord- 
ing to Dr. Pollock, " a still greater number are preceded by 
rheumatism." — Sparks, p. 105. 

Amongst the numerous valuable reports which Dr. Bu- 
chanan, in his official capacity of Health Inspector, submit- 



40 

ted to the Privy Council of England, there is perhaps none 
which is of more interest than his report on " The Distribu- 
tion of Phthisis as afiected by dampness of soil." Dr. B. 
ascertained that in certain towns that had been drained, 
that the mortality from phthisis had greatly diminished, 
and the rate of diminution was found to correspond with 
the extent of the drying of the soil. It was found that 
wherever the drying of the subsoil had been effected either 
by the construction of drain sewers, or by special drains, 
the mortality from phthisis had decreased from about 50 
per cent, downwards. From a thorough and prolonged 
investigation of the subject, Dr. Buchanan determined that 
"there was much less plithisis among populations living on 
pervious soils, than among populations living on impervious 
soils." That there was ''much phthisis with much wetness 
of soil, and little phthisis with little wetness of soil." 

But the priority of investijjating the influence of wet soils 
as a cause of pulmonary diseases, is due to Dr. Bowditch, 
of Boston, Massachusetts. lu an address delivered before 
the Massachusetts Medical Society, in 1862, Dr. B. remarked 
that " Medical opinion in Massachusetts, as deduced from 
the wrilteu statements of physicians of 183 towns, tends to 
prove the existence of a law in the development of consump- 
tion in Massachusetts, which law has, for its central idea, 
that the dampness of the soil of any township or locality is 
intimately connected, and probably as cause and effect with 
the prevalence of consumption in that township or locality." 
" But, in addition to phthisis, there are other diseases whose 
prevalency is largely affected by dampness of soil. Thus, 
rheumatism, catarrhal complaints and ague are especially 
common in damp districts. An undrained or damp state of 
soil is fully proved to be highly inimical to health, and 
according to 5lr. ISimon, it answers to the legal definition of 
the term nuisance."* "Dampness of soil may presumably 
effect health in two ways. First, by the effect of water, per 
se, causing a cold soil, a misty air, and a tendency, in per- 
sons living on such a soil, to catarrhs and rheumatism ; and 
second, by aiding the evolution of organic emanations. A 
moist soil is cold, and is generally believed to preilispose to 
rheumatism, catarrh and neuralgia." "j" A sandy soil at a 
suitable elevation to ensure ped'ect drainage without an 
impervious layer of clay near the surface, will be a dry soil, 
and a clayey soil, on the contrai-y, a moist soil. Soils con- 

* Hand book of TTyc;ieiie, G. Wilson. M. D., 187.S, p. 272. 
f Practical Hygieue, K. A. Parkes, M. D., p. 306. 



41 

taining an excess of organic elements are injurious, for 
they tend to produce malarious diseases, so injurious to 
invalids. 

Dry, sandy or gravelly soils, at a sufficient elevation to 
insure perfect drainage, will be, caeteris paribus, more healthy 
than a cold, clayey soil, or even a sandy soil, with water near 
the surface at a higher elevation. And before a physician 
advises a patient to visit a given winter resort, he should 
acquaint himself with the peculiarities of the locality as 
regards soil and moisture ; for if a cold, moist soil is pro- 
ductive of disease, a locality where such soil exists cannot 
be favorable for the invalid, and should be avoided. Dr. 
Jones, of St. Paul, Minnesota, says that "those localities 
only should be recommended, where the soil is sandy, or 
highly pervious to water, and where rain-fall is rapidly ab- 
sorbed." These conditions exist to a marked degree in a 
large portion of this State ; hence its advantages as a cli- 
matic resort. 

To establish the advantages of cold climates, and Min- 
nesota in particular, in the treatment of consumption. 
Dr. Jones refers to the infrequency of this disease in Ice- 
land, Nova Scotia, Norway aud Sweden. At p. 289, he 
remarks : " The geographical location of Minnesota pro- 
tects her from all oceanic influences. It need scarcely 
be repeated that this marine atmosphere is a fruitful 
source of mischief to consumptives, as indicated by the death 
rate of those persons residing in situations where this influ- 
ence is operative. It is not surprising that Florida should 
suffer, from this scourge, when we remember that it is a j)en- 
insula, and, therefore, exposed on two sides to this oceanic 
influence." But mirabali dictii ; his whole plea for "cold 
climates " is based on the absence of phthisis in countries 
subjected to " oceanic influences." Iceland is surrounded 
on four sides by water. Nova Scotia is almost an island, 
and Norway and Sweden are more of a peniusula than Flor- 
ida. If " oceanic influences" are so deleterious in this State, 
why not in those countries ? In my opinion, the remarka- 
ble exemption from consumption in Florida is, to a great 
extent, to be attributed to the fact that it is nearly sur- 
rounded by water, and that it is nearly always subjected to 
" oceanic influences," as Iceland, Norway, Sweden and Nova 
Scotia. 

Dr. Packard, surgeon to the Episcopal Hospital, Phila- 
delphia,' s*ays : "We are told bjMneteorologists, that the 
sea air contains more ozone than inland places. It may be 
taken as a fact, that the presence of oxygen in this form ia 



42 

one important element of the tonic and stimulating effect of 
the atmosphere of the sea-shore. Hence, we have at the sea- 
shore a jntre air, containing oxygen in the form of ozone. 
Upon most persons the effect of breathing this air is tonic 
and invigorating, producing an immediate sense of exhilera- 
tion, imoroving the appetite, and promoting digestion." 
Pages 21, 22. 

In opposition to the vievps of Dr. Jones, many leading 
physicians in England and on the continent seed their pa- 
tients to the sea-shore in summer and v?inter ; and in tbe 
North, more especially in Philadelphia, leading physicians 
even send their patients to sea-side resorts in winter. Dr. 
Packard writes : *' Children recovering from lung troubles, 
as bronchitis, whooping-cough, etc., are sent to Atlantic 
City or Cape May, in the latter part of winter. For many 
consumptives, as well as for those who labor under chronic 
bronchitis, the sea-shore affords a most valuable winter 
resort. The purity of the air, with the greater equability of 
temperature, enable them to breathe more easily, and it is 
sometimes surprising to note the diminution in the severity 
and frequency of the cough. A like beneficial effect is pro- 
duced upon asthmatics, who, indeed, are very often subjects 
of chronic bronchitis."* 

The water supply of a health resort may appear to be a 
trivial matter, but it is one of special importance to the in- 
valid. Impure water has long been recognized as one of 
the most potent causes of disease, and it is only of late years 
that minute investigation has succeeded in demonstrating 
the great mortality which it inflicts on all classes of the 
community. In many localities in the South, the water is 
impregnated with vegetable matter, and should be avoided 
by the sick. In the older towns, more especially if the soil 
is sandy, and if sanitation has been neglected, the well water 
is apt to be contaminated with the drainage of water closets 
and kitchen slops, and, as a consequence, unfit for use, and 
productive of typhoid fever and intestinal derangements. 
In my numerous visits to the country districts of this State, 
I have frequently met with persons with enlarged abdomens, 
and waxy complexions, traceable, in almost every case, to 
the use of bad water and improper food. Whenever the 
residents of this State drink pure water and live on digesti- 
ble and nourishing food, sickness and broken health will be 
found to be less than in any State east of the Rocky Moun- 
tains. As so many dangers lurk in apparently pure water, 

•Sea Air and Sea Bathing, by J. H. Packard, Philadelphia, 1880. 



43 

invalids and strangers should, if possible, drink rain water 
whenever obtainable ; and in selecting a hotel or boarding 
house at any winter resort, strict inquiry should be made 
with regard to the water supply, its source and quality. 
"The drainage and water supply," remarks Sparks, p. 245, 
*• of a health resort, are scarcely, if at all, less important than, 
its climatic conditions, because if people are to be poisoned 
by sewer gas, or poisonous sewage contamination, they had 
better stay at home." 

Malaria is a subject which enters into the discussion of 
all Southern climes, and we unhesitatingly assert that Flor- 
ida has been misrepresented in this respect. " It is the cus- 
tom," remarks Dr. Lente, p. 21, "of many persons living at 
Florida resorts, oif the St. Johns river, to represent for ob- 
vious reasons, that fever prevails there the year round, and 
that it is dangerous to resort to it at any time. In this 
manner they have excited senseless alarm in the minds of 
those proposing to come to Florida, and have diverted them 
to other Southern resorts, thus in the end injuring them- 
selves as well as others." Unprincipled hotel keepers and 
runners, and the agents of steamboat and railroad lines lead- 
ing to other localities, aid more or less in this fraudulent 
attempt to gain patronage. The bugbear, malaria, is, in my 
humble opinion, a prolific source of disease among visitors 
to Florida. By misrepresentations (to use a mild term) 
tourists and invalids have been led to believe that the entire 
water supply is productive of disease, and as a consequence, 
they refrain from drinking a sufficient quantity of water, or 
dilute it with poor whisky or brandy, to counteract its bad 
effects. Interested parties have expatiated so much with 
regard to the air being charged with malaria in winter, that 
invalids and patients become alarmed, and as a sequence 
they daily swallow quinine, and thereby produce nervous or 
functional derangements. They keep the pure air out of 
their rooms, breathe an air contaminated with their own 
breaths and exhalations, and at night assemble in halls and 
parlors and inhale vitiated air poisoned by their own breaths 
and the elements resulting from the combustion of coal gas 
and kerosene. They inhale for hours at a time, air charged 
with carbonic acid, and shun the pure night air as they 
would the emanations of the deadly Upas tree. Visitors act 
imprudently, and as a consequence, suffer from nervous 
derangements, colds, and diarrhceas, which they attribute to 
malaria or the climate. The cause of slight indispositions 
affecting visitors, is not malaria, but indulgence at table, 
change of drinking-water, eating excessive quantities of 



44 

fi'uit, or the inhalation of air poisoned by human breaths, or 
the resultants of the combustion of coal j^'as and kerosene, 
and a deficiency of the pure air that a beneficent Creator 
has placed everywhere within their reach. If visitors would 
let quinine and arsenical pills alone, control their appetites, 
eat moderately, inhale plenty of the salabrious air of the 
State, and not swelter in heated halls, parlors, and unventi- 
lated bed-rooms, we should hear less of the bugbear, mala- 
ria. At various times since 1844, I have navigated the 
larger streams of this State, visited the Everglades and Lake 
Okeechobee, and almost every bay inlet and river, from 
Cape Sable to the Suwannee River, and for over two months 
at a time, slept in an open boat, with nothing but a simple 
awning stretched over the boat's boom, and in no instance 
did my companions or self suffer from malaria or a chill. 
Before I became a resident of the State, my companions and 
self were unacclimated, and in no instance were we so fool- 
ish as to swallow quinine, arsenic, or alcoholic liquors aa 
antidotes to malaria or chills. I speak from personal ob- 
servation, experience and extended inquiry in various por- 
tions of the State, and I unhesitatingly assert that the opinion 
entertained with regard to the prevalence of malaria during 
the cold months in Florida, is unfounded. When discussing 
the advantages of Florida as a climatic resort, the eminent 
Dr. Forry predicted : " From a long residence in Florida, 
attached to the United States Army, that when the period 
of the red man's departure shall have passed, the climate of 
this land of flowers would acquire a celebrity as a winter 
residence not inferior to that of Italy, Madeira, or Southern 
France."* 

"All know," remarks Dr. Brinton, p. 128, "how terribly 
arduous must be campaigning among the Everglades of 
Florida, yet tlie yearly mortality from disease of the regular 
army there, was only 26 per 1,000 men ; the average of the 
army elsewhere was 35 per 1,000, while in Texas it rose to 
40, and on the lower Mississippi to 45 per 1,000." If per- 
sons are suffering from malarial cachexia they may have 
chills at any season in any climate. But a few weeks since 
I was requested to visit a young lady visitor, whose home is 
Fifth Avenue, New York. The only time she had been 
dressed for three months, was the day she was driven to the 
Savannah steamer. Upon inqury, I found that quinine, 
arsenic, and Warbeck's tincture, had failed to cure her of 
chills. She arrived in this city in the latter part of Feb- 

* Copeland'a Dictionary of Medicine, vol. 1, p. 417. 



45 

ruary, and at the end of two weeks she departed for home, 
sans chills, t^ans malaria, sans debility. From my experience 
in hospitals and private practice in and near New York, I 
have no hesitation in stating that malarious diseases are 
moi-e frequent there than ia Florida. From my observa- 
tions from Canada to the Gulf of Mexico, I am convinced 
that febrile diseases assume a milder form, and are more 
easily cured in Florida than in States to the north of it. I 
shall no doubt be met with the reply : " Look at the waxy 
complexions and gaunt forms of many Floridians, met with 
at some of the landings and depots." I admit the mild im- 
peachment, and can attribute their cachectic condition to 
bad water, insufficient clothing, unsuitable and uncomforta- 
ble habitations, and the improper food they eat from child- 
hood to the grave. In any other State but Florida, they 
would be the victims of enlarged spleens, cardiac dilatation, 
chronic gastritis, tuberculosis, dropsical effusions or albu- 
minuria. But contrast the natives referred to with those 
who have comfortable homeS; sufficient clothing, and who 
drink pure water and use good and nutritious food ; or with 
Northern and Western people who have been in the State 
for years, and the latter will be found to be pictures of 
health. I admit that in Florida, as everywhere else, there 
are insalubrious localities, but they should be avoided by 
strangers. But to avoid them, interested parties should 
not listen to the senseless twaddle of irresponsible hotel 
keepers, hotel and steamboat and railroad runners, or 
strangers suffering from a severe attack of Aerophobia. A 
majority of the cases of illness occurring among visitors in 
this State, are referable to indulgence at table, drinking 
impure water, the inhalation of impure air, the American 
weakness of rushing hither and thither, occupation of un- 
ventiiated rooms, and a ridiculous system of senseless drug- 
ging indulged in by strangers, as a consequence of the 
advice given by physicians who are ignorant of the climate 
and its diseases. To illustrate the frequency of malarious 
diseases — intermittent and other fevers during the cold 
months in this county, I have examined the records of the 
county hospital under my superintendence, and find that 
the following cases of malarious diseases were admitted for 
the five cold months of '79 and '80 : 



46 



K 


OS 




H 


H 


H 


^ 


M 


W 


m 


K 


■< 


S 


S 


■< 


p 


u 


u 


D 


a: 


> 


u 


"ir 


n 


o 






H 


^ 


tt 


^ 


fo 


1 











1 




































Remittent fever 10 

Intermittent fever 10 

Congestive fever 

Typho Malarial fever 

When we come to estimate the influence of climate on 
health, we should consider adjuvants outside of climatic fac- 
tors. To insure success in the treatment of disease or broken 
health, something more is necessary than dryness of air and 
a moderate range of temperature. The locality selected 
should present various attractive features, so as to keep the 
patient from brooding over his infirmities. The invalid 
requires cheerful society, sources of amusement and occupa- 
tion, an opportunity to walk, ride, drive, boat, fish, botanize 
and enjoy sunshine, and day by day, and hour by hour, find 
some source of divertisement. 

The importance of pure air (uncontaminated with noxious 
effluvia and germs so common in interior sections), more 
especially that of the ocean, has not received the attention 
its importance demands. 

Ozone is considered by many as an important constituent 
of the atmosphere, for by its " presence pure air may be in- 
ferred to exist." This allotropic condition of oxygen pos- 
sesses a great power of destruction of organic matter floating 
in the atmosphere. Dr. Jones, of St. Paul, lays great stress 
upon the importance of ozone in the climatic cure of pulmo- 
nary diseases, and intimates that Minnesota is favored in 
this respect, as there is much more of this substance in the 
" higher than in the lower strata of the atmosphere," and 
that this is an argument against " sending patients to Flor- 
ida." At another point he informs us that "the air of the 
sea and mountains is richer in ozone than the atmosphere 
of the plains." If Dr. Jones' statement is accepted as fact, 
Minnesota is not suited to consumptive patients, for it is not 
surrounded by the ocean, nor is that State favored with 
mountains. The Florida peninsula is surrounded by the 
sea, and as the land is almost constantly fanned by sea 
breezes containing a large amount of ozone, the " Land of 
Flowers " must of necessity be better adapted to the climatic 
treatment of pulmonary diseases than Minnesot i. Accord- 
ing to Sparks, p. 410, " it seems clear that the substance 



47 

giving the reaction of ozone is not deficient in marshy dis- 
tricts." According to the researches of Burdel, he found as 
" much ozone in the air of marshes as in other air." Cle- 
mens says : " There is a large proportion of oxygen near 
the surface of lakes, giving the reaction of ozone," more 
especially if there are certain acquatic plants present ; and 
he also remarks that at some feet above the surface, the 
reaction is lost. Grallois has lately stated that he " found 
more ozone over marshes than anywhere else." Dr. Schrei- 
ber, of Vienna, asserts "that the turpentine exnaled from 
pine forests possesses, to a greater degree than all other 
substances, the property of converting the oxygen of the air 
into ozone. " In this connection, Dr. Denison remarks : " If 
this be true, it will explain why a residence among the bal- 
samic odors of the pines has long been esteemed of benefit 
to the pulmonary invalid." Florida is densely covered with 

Sine forests, and if we accept the statement of Dr. Schreiber, 
>r. Jones is in error. Dr. Moffat found the quantity 
of ozone in the atmosphere greater when the mean daily 
temperature was above the mean. According to the re- 
searches of Dr. Denison in Colorado, the excess of ozone 
appeared durmg the spring months on the plains, and came 
proportionately later in the season the higher up the obser- 
vations were made." If we accept as correct the statements 
of the authorities quoted, and Florida is amply supplied 
with ozone, and if according to the statement of Dr. Jones, 
"ozone is exceedingly valuable in the climatic treatment of 
phthisis," patients should be sent to Florida in winter, and 
to elevated and mountainous regions during the summer. 

" Food, the kind, quality, and the manner of its prepara- 
tion, is a matter of no small importance to the invalid, and 
no climate, however suitable in other respects, is proper for 
him, if he cannot obtain good and decently cooked food." — 
Lente, p. 43 In phthisis, food is a matter of more impor- 
tance than medicine, and this subject is sensibly referred to 
by Dr. Bennet. " The food taken by consumptives should 
be of the most nourishing kind, well cooked and abundant 
in quantity. Indeed, the quantity of food taken by con- 
sumptives should only be limited by their digestive powers. 
In my opinion the principal value of medical treatment in 
phthisis is the restoration of digestive tone, when impaired 
or absent. If patients can be brought to eat, to digest and 
to assimilate, they have a chance of recovery. If they can- 
not, their chance is indeed slight." One great objection to 
many portions of the South, as winter resorts for invalids, 
is Southern cooking, which, in some localities, is character- 



ized by the use of excessive quantities of grease and the 
ever-present corn bread and bacon. But in the cities, 
towns, and the better class of winter resorts, the cuisine is 
all that can be desired. In some hotels, the tables cannot 
be excelled by those of the North. 

The character of the buildings at a health resort has much 
to do with the successful treatment of disease, and this sub- 
ject does not receive due and proper consideration. In 
some portions of the South the buildings are poorly con- 
structed, and in some instances unsuited to the requirements 
of the invalid. The invalid should select a well constructed 
building, sufficiently elevated above the surface of the soil, 
where the soil is dry, and permanent water is at considera- 
ble depth below the surface. 

Considering climatic factors, as a result of experience, 
observation, investigation and study, we are convinced that 
Florida presents more attractions and advantages as a win- 
ter resort for invalids than any State in the Union. The 
temperature is favorable, the mean relative humidity is pe- 
culiarly adapted to the treatment of all forms of pulmonary 
disease, the air is salubrious, and in a large portion of the 
State dry and bracing ; atmospheiic changes are infrequent, 
and not so great as in other sections east of the Kooky 
Mountains. Rains are infrequent, and sunshine and fiue 
weather the rule. The State possesses insular, interior, dry 
and moist localities, semi-tropical and cooler sections ; and 
if the nature of any given case should necessitate a change 
of base, a suitable climate can be reached in a few hours and 
at a trifling expense. 

For fear of being accused of painting Florida in too bright 
colors, we shall' use the language of others : 

" The atmosphere is generally dry and clear, owing to the 
evenness and salubrity of its climate. Florida hits long 
been a popular resort for invalids, and especially those 
afflicted with pulmonary complaints. Of the total deaths 
from all causes in Florida in 1870, as reported by the Fed- 
eral census, only 131 were from consumption. There were 
17.3 deaths from all causes to one of consumption. The 
advantages of the climate in this respect are further shown 
by a comparison of the statistics relating to consumption as 
reported by the census of 1870, from which it appears that 
the ratio of deaths from consumption to those from all 
causes, was less in Florida than in anv State except Nevada ; 
and this advantage becomes st\ll greater when it is consid- 
ered that, Florida being a popular resort for consumptives, 
o large proportion of those who die there from that cause 



49 

came with the dif^eme from other States."* It must be 
remembered that the first immigrants to a new State like 
Nevada, are, as a rule, robust aud possess good constitu- 
tions ; and we must wait for a few decades before we can 
arrive at a correct conclusion with regard to the prevalence 
of phthisis. My observations, extending over three years in 
our county hospital, justifies me in stating that a very large 
i:>roportion of the cases of phthisis admitted into the insti- 
tution were the result of constitutional syphilis, and not 
atti'ibutable to climate. 

Dr. Charles A. Lee, the learned editor of Copeland's Med- 
ical Dictionary, remarks : " Proceeding south from Canada 
to Florida, the seasons become more uniform in proportion 
as their annual temperature increases, aud they glide im- 
perceptibly into each other, exhibiting no great extremes. 
Compared with the other regions of the United States, the 
peninsula of Florida has a climate wholly pecuUar. The 
climate is so exceedingly mild and uniform, that besides the 
vegetable productions of the Nortlaern States generally, 
many of a tropical character are produced. We have already 
spoken of the mildness of the climate of this region ; it ap- 
pears to possess an insular temperature not less equable and 
salubrious in winter than that afforded by the South of 
Europe, aud is, therefore, well adapted to those forms of 
pulmonary disease, as bronchitis and incipient phthisis, as 
are benefited by a mild climate. Mildness and uniformity 
are the two distinguishing characteristics of the Florida 
peninsula. If we compare the climate of East Florida with 
the most favored situations on the Continent of Europe, and 
the islands held in the highest estimation for mildness and 
equability of temperature, in regard to the mean tempera- 
ture of winter and summer, that of the warmest and coldest 
months, and that of successive seasons, we shall find the 
results generally in favor of the former-." After citing the 
mean difference of successive months and annual range of a 
number of climatic resorts in comparison with stations in 
Florida, he remarks : " Thus it is easily demonstrated, that 
invalids requiring a mild winter residence, have gone to 
foreign lauds in search of what might be found at home — 
an evergreen land, in which wild flowers never cease to 
unfold their petals."f 

In discussing the most suitable climates for invalids. Dr. 
Wilson, late Medical Inspector of Camps and Hospitals, 

* American Encylcopedia, vol. vii, p. 281. 

t Copeland's Medical Dictionary, vol. 1, pp. 402, 404, 41G, 



60 

United States Army, remarks : " Neither upon the soutji- 
ern coast of France, nor anywhere under the bright Itahan 
skies, can a winter climate be found so equable and so genial 
to the delicate nerves of most invalids as can be enjoyed in 
our sanitary stations in Florida."* 

Dr. H. A. Johnson, of Chicago, states : " I had about fifty 
patients last winter in Florida and Georgia, and they came 
back better. Even in those in whose lungs cavities existed, 
were better than they would have been had they stayed in 
Illinois. I will, tlierefore, advise patients in the latter stages 
to go to Florida. "f 

At page 1235, vol. 3, of Copeland's Dictionary of Medi- 
cine, we find the following : '• Dr. Forry and other writers 
of authority, recommend a change of climate in this disease, 
as a remedial agent of great efficacy, and especiuUy the pe- 
ninsula of Florida." 

0\er half a century ago. Captain Vignoles, an intelligent 
gentleman, traversed a large portion of Florida, and wrote : 
" That the climate is good for patients of a consumptive 
habit is notorious, several persons during the last winter and 
spring from Carolina and elsewhere having recovered their 
health ; and that the air is not at any season hurtful is 
equally well known. The fashion of sending invalids on an 
expensive journey to the south of France and Italy, may be 
superseded, if physicians could be induced to recommend a 
winter in Florida to their patients. The attention of the 
faculty is seriously entreated by the author to this subject, 
and to the propriety of ordering their debilitated patients to 
try the salubrious air of Florida."| 

Florida is hot esteemed by all as a climatic resort for 
invalids, and I shall quote from Dr. Jones' Essay, pp. 277, 
278. He says : " Florida, which has been vaunted as a 
sanitarium for invalids, shows a greater ratio of mortality 
from phthisis, to-day, than Minnesota. Florida is, perhaps, 
to-day, more frequented by invalids than any of our South- 
ern places of resort. The exceeding fatality of consumption 
to families who for generations have resided in the State, as 
well as the unfavorable effects, as a rule, observed upon 
patients who visit that State in declining health, is well 
known. We are not surprised that such is the case, after 

* Health and IJealth Resorts, J. Wilson, M. D., Philadelphia, 1880, 
p. 26. 

t Trans. Am. Med. Congress, pp. 422-3. 

I Observations on the Floridas, by Charles Vignoles, New York, 
1823, p. HI. 



51 

having carefully analyzed the climate, for there is little that 
can be said in its favor, and a great deal which must be said 
against it." 

In making such a sweeping statement, in which the wel- 
fare arrd progress of a State is involved, it would have been 
but just and professional for the writer to have furnished 
references to authors, resident physicians, or statistical evi- 
dence to substantiate his assertions. But his unauthorized 
statements is evidence of the assumptions of ignorance in a 
person who is disposed to injure a State, of which he has no 
personal knowledge, no reports from resident physicians, or 
no reliable data upon which to base an opinion. 

In this State we have no State Board of Health, and no 
compulsory registration of deaths, and it was impossible for 
Dr. Jones to base his statements upon any evidence but the 
United States Census, and the Army Reports, and mortuary 
returns of this city, and these are favorable to the State. If 
Dr. Jones had been impartial and disposed to adopt a pro- 
fessional course, he would have written : " Florida is a 
favorite resort for invalids. Many persons visit the State in 
the last and incurable stage of phthisis and die there, as 
everywhere else ; and as we have no mortuary tables, or the 
means of ascertaining how many residents or invalids an- 
nually die in that State of phthisis, we are not justified in 
expressing a positive opinion." But such a professional 
statement would not have aided the gentleman in accom- 
plishing his end. 

In his essay. Dr. Jones refers to the great mortality in the 
city of Jacksonville, and as rtliable data are important, I 
addressed Dr. Knight, Health Ofl&cer of the city, and received 
the following reply : 

" Residents who died during years of 1878 and 1879, from 
phthisis, 11. Percentage of deaths bv phthisis to total mor- 
tality, 0.55." 

Dr. Jones asserts that the mortality from phthisis is great 
in families that have lived in Florida for generations. The 
writer did not institute a personal investigation, or cor- 
respond with our leading physicians, and as no State mor- 
tuary reports have* been published, the question arises, 
" From what source did Dr. Jones obtain his information ?" 
A statement of this kind requires side evidence in the way 
of statistics, mortuary reports, or reliable information — not 
mere assertion, based on preconceived opinions. My obser- 
vations and inquiries led me to the opposite conclusion, but 
being loth to express a positive opinion in opposition to that 
of an eminent member of the profession, I addressed a circa- 



52 

lar letter to leading physicians in various portions of this 
State, and shall give a few queries propounded and the an- 
swers received. 

Query. — How long have you practiced medicine in this 
State? 

Answers. — Twenty-eight years. Twenty-two years. Twen- 
ty-three years. Twenty-four years. Twenty-five years. 
Twelve years. Seven years. Thirty years. Thirty-six 
years. Twenty-eight years. Twenty-one years. Thirty years. 
Twenty-one years. Forty-two years. Five years. Forty- 
nine years. Thirty years. 

Query. — Have you noticed any tendency to the hereditary 
transmission of phthisis in families that have resided for 
generations in this State? 

Answers. — None. None of a marked character. Hardly 
an instance ; so seldom as to make it an exception. No. 
No. None. In one family for three generations members 
died of phthisis ; the present members of the family are 
quite healthy, and I am convinced the hereditary tendency 
is removed. In one instance only. Not more so than in 
other States. I have no recollection of any case. Seldom 
developed, and when it occurs, milder and more favorable 
than in Northei-n and Western States. In some rare in- 
stances. Not more so than in other families. Hereditary 
taint dies out. Know famihes here born of consumptive 
parents, who have passed the meridian of life and exhibit 
no signs of pulmonary disease. 

In the ipse dixit of Dr. Jones, we have the opinion of a 
theorist who studied the climatologfy of this State, and the 
hereditary transmission of phthisis in our old families, in 
his cosy sanctum in St. Paul. And, in opposition to his 
assertion, we have the positive statements of educated, ex- 
perienced and i-eliable medical gentlemen — gentlemen who 
are competent to form intelligent and unbiased opinions, 
and whose aggregate experience in the profession covers 433 
years, or an average of over 25 years. 

To determine the question of transmissibility of phthisis 
in this State, in families predisposed to this disease, I pro- 
pounded the iollowing queries : 

Query. — Do you knovv any persons who are residents of 
this State, who came here sufl'ering from phthisis, and who 
have had children since they became residents? 

Answers. — Yes I do. Yes, more than a dozen. Several. 
Several. Yes. Yes. Yes. I do. Yes. A number. Yes. 
Yes. Quite a number. There are many to my knowledge. 
Yes. 



53 

Qtteky. — Have you noticed any disposition among chil- 
dren of such parents to manifest any hereditary tendency to 
phthisis ? 

Answers. — No, I have not. Not in any case. No. None. 
None. No. No. No. I have not ; their children are as 
healthy as any I have seen in any part of this couutry. In 
two instances only. No ; children of such persons are 
healthy. No. Have noticed no such tendency in such chil- 
dren. No. Very infrequent. None. 

Dr. Jones refers to the " unfavorable effects, as a rule, ob- 
seived upon patients who visit Florida in declining health." 
As his essay is devoted to the consideration of climatic 
treatment of phthisis, we must conclude that by " declining 
health " he means phthisis. If the opinion of Dr. J. is cor- 
rect, it is surprising that thousands of persons visit Florida 
each winter for their health, and that t e number increases 
annually. In my visits to various portions of the State, I 
have met numbers who have settled here as invalids, who 
have been cured by the climate, or who are in the enjoyment 
of fair health. Like Dr. Jones, I have " carefully analyzed 
the climate," but am not disposed to hazard a positive 
opinion ; hence I shall quote queries from my circular let- 
ter, and give the replies received. 

Query. — Is tubercular consumption as liable to be devel- 
oped here as in the northern and northwestern portion of 
the United States, in persons predisposed to the disease ? 

Answers. — No, sir. No. It is not. From my experience 
North and South, I unhesitatingly say no. No. No. I 
think not. I have not seen an instance in which it was 
developed in a person predisposed to it. It is not No. 
There are very few cases developed in this climate. It is a 
rare thing for phthisis to be developed in this State in the 
predisposed. No. Such has not been my experience. It 
certainly is not. No, it rarely occurs. No. * 

Query. — Does the climate of Florida favor the cure of 
phthisis develop3d elsewhere'^ 

Answers. — Most certainly. It certainly does, and 'especially 
in those whose lungs are softened and tubercles and cavi- 
ties exist. It does, as I know from observation. In my 
opinion, decidedly yes. In most cases. If persons avail 
themselves of the climate sufficiently early. Yes. It does. 
Yes. I have known many cases cured by coming to this 
climate. It does ; I have known many cases cured, and 
others relieved and life prolonged to old age. I Ijave 
known many cases cured by coming to this climate. Yes. 
I am sure it certainly does. It does ; I have known many 



54 

cases. Yes, advanced cases are often cured by this climate. 
It does. 

Query. — Do you know persons now living in this State, 
or elsewhere, who came here suffering from phthisis, either 
incipient or developed, who have been benefited by a resi- 
dence here ? 

Answers. — Yes, many of them. I do. A great number. 
Quite a number whom I can namo. Several. Yes. Yes. 
Yes. I do. I have seen many benefited during my resi- 
dence here, and I know of quite a number now living here, 
who have been cured by a residence in this State. Yes. 
Several instances (names and residences given). Numbers 
of cases. I have known many persons who have been 
restored to health, and many whose health has been im- 
proved. I know many such. Yes, I can mention many. 
Several. 

Query. — Do you consider the climate of this State favora- 
ble to the treatment and cure of pulmonary diseases ? 

Answers. — In my opinion, it is the finest climate in the 
' world for tubercular diseases. I have seen so many bene- 
fited, that I would recommend it in almost every case. I 
do above any other that can be found on the American con- 
tinent. Decidedly. I do. More so than in any State in 
which I have lived. Yes. All are not benefited ; many 
certainly will be. I certainly do. I consider it the most 
favorable climate on this globe for the relief and cure of 
phthisis. Superior to any in the United States. Yes, most 
positively. Yes. Most certainly ; I have known numerous 
cases fully restored here and have returned North and 
remained well. I do. I do, decidedly. I do. 

In his essay, Dr. Jones informs us that he has " carefully 
analyzed the climate [of Florida], and little can be said in 
its favor, and a great deal must be said against it." As 
Captain Cuttre would say, " Here's whisdom for you, intense 
whisdom." The inquirer after truth has a right to require 
that scientific doctrines which he is asked and expected to 
receive as true, should be supported by observation, facts, 
experience, or statistics — not by assertions and statements 
ot writers who are ignorant of the climatic conditions of a 
locality they are condemning. 

All Dr. Jones' conclusions appear to be based on the fol- 
lowing sentence : " Hygrometric measurements show that 
the almo^phere of Florida is loaded with moisture." But the 
Doctor carefully avoids the publication of any data or tables 
regarding the mean relative humidity of Florida. We have 
placed before you reliable meteorological data, which we 



55 

think will establish the fact that Florida possesses a dry 
climate, and that Dr. Jones' statement is unfounded and 
cnlculated to mislead. It is not the misrepresentation of a 
State alone which is censurable. If Di\ Jones' statements 
are incorrect, numerous invalids may be misled and injured, 
and in our opinion, this is an important consideration. 
When life and health are at stake, writers should not hazard 
statements upon mere conjecture or popular opinion. 

One of the most amusing assertions of Dr. Jones, in con- 
demnation of Florida, is the following : "In Florida every- 
thing unites to repose ; an irresistible feeling of languor 
seizes a person ; one's energies are paralyzed, and exercise 
consequently neglected." It is evident that the Doctor 
never visited this State, or he would not have hazarded 
such a statement. I am forced to entertain views oppo- 
site to those of Dr. Jones, but as I am too modest to 
express a positive opinion based on my own feelings and 
experience, I propounded the following query in my circular 
letter : 

Query. — Do you consider the climate of this State, from 
October to May, bracing and invigorating, or enervating 
and depressing? 

Answers. — Bracing. Bracing and invigorating. Bracing 
and invigorating. Dry and stimulating. Bracing. Bracing 
and invigorating. Bracing and invigorating. Invigorating 
and bracing. Bracing and not relaxing and depressing. 
Bracing and invigorating. Invigorating and bracing. Brac- 
ing, invigorating and delightful. From November to May 
this climate exerts a tonic influence on invalids. Climate 
from October to May, quite invigorating. Decidedly 
bracing and invigorating. Bracing. Bracing and invigo- 
rating. 

I have given you the views of a climatic theorist, and the 
positively expressed opinions of the leading physicians of 
this State, and I need but remark that if the latter are 
believed, Dr. Jones has made erroneous statements, which 
are calculated to mislead and injure invalids, by diverting 
them from a temperate, dry and bracing climate to a locality 
where the " Ice King is " — where atmospheric changes are 
great, and where the mean relative humidity during the 
winter months is greater than that of Florida. 

Di'. Jones informs us, in his "plea for cold climates" (and 
Minnesota in particular), "in the treatment of pulmonary 
consumption," that " to ascertain the opinion of the profes- 
sion of this State [Minnesota] concerning the effects of 
climate upon phthisis, the Minnesota State Board of Health 



56 

recently sent out a circular, and received the following 
replies." Among the inquiries was the following : 

Question VII. " What months are most favorable for im- 
migration here?" 

" Forty answers. Autumn, eight ; summer, twelve ; spring, 
five ; late spring and early fall, ten ; any month, two ; unde- 
cided, three." 

It is remarkable that none recommended the winter 

months, more especially, as the object of the circular was to 

prove that Minnesota is, par excellence, the most suitable 

winter resort for invalids ; and more especially as Dr. Jones 

, has asserted its superiority. 

Desirous of ascertaining the views of our leading physi- 
eians, I included tlie following inquiry in my circular letter ; 

Query — What months are the most favorable to immi- 
gration to this State ? 

Answers. — All seasons. Fall and winter months. Winter 
months. October 1st to April 1st. September to March. 
October to May. Whenever one gets ready. Winter months. 
Fall and winter months. October. Fall and winter. Fall 
and winter months. October to April. Winter months. 
All seasons are equally favorable for invalids. October to 
June. Fall and winter months. Fall and winter months. 

At page 296, Dr. Jones asserts " that it is difficult to un- 
derstand the reason why the profession in this country still 
persists in sending their patients to Florida. T^at im- 
provement should take place is against reason and experi- 
ence alike. Il we except a sandy soil, it does not possess 
a single element which is now regarded as favorable for the 
palliation or cure of phthisis." In Dr. Jones, we have a 
dogmatist, who writes about "reason and experience." His 
reasons are simply based on ignorance ; the assertion that 
"the atmosphere of the State is loaded with moisture," and 
" meteorological tables for the year 1878, for the city of St. 
Paul." He arrogantly censures the profession for sending 
their patients to Florida. This can be accounted for on the 
ground that many members of the profession are posted 
with regard to the climatic advantages of Florida, and that 
Dr. Jones is a resident of Minnesota. He speaks of "expe- 
rience," of which he has not had jot or tittle. If he had 
resided in this State for but twelve mouths, he might have 
referred to his limited " experience ;" but when a non-resi- 
dent refers to " experience," it is simply descending from 
the sublime to the ridiculous. He asserts that with the 
exception of a "sandy soil the State does not possess a sin- 
gle element which is now regarded as favorable for the 



57 

palliation and cure of phthisis." I have quoted from leading 
authorities regarding the climatic factors " necessary for the 
alleviation and cure of phthisis," and have discussed the 
factois of this climate, and have given meteorological data, 
and, in my opinion, there is but one conclusion to be arrived 
at, and that is that Dr. J. is a dogmatist, and one who is 
ready to assert as fact what he cannot establish by experi- 
ence, testimony or reliable data. 

In his essay, Dr. Jones uses the following language : 
" The mortality of St. Paul is less than that of Jacksonville." 
Questioning the correctness of this statement, I addressed 
a note to Dr. Jones, requesting him to favor me with the 
mortuary reports of St. Paul for the years 1878 and '79, 
with his authority for the statement regarding the mortality 
of Jacksonville, and that the atmosphere of Florida is 
"loaded with moisture." But received no reply.* 

To condemn localities of low elevation, as well as those 



* Since this paper was placed in the hands of the Publication Com- 
mittee, I have received a cominunication from Dr. Jones, dated June 
21st, in which he states; 

" The mortality of Jacksonville, Florida, was found in some medi- 
cal journal, or in the transactions of your State Medical Society. I 
cannot now remember wh'ch. I do remember, however, that the 
mortality from consumption in Jacksonville was greater than in St. 
Paul. 1 am well aware how unreliable such information is. The 
humidity of the atmosphere of Florida is so well understood, that to 
answer you as to where I received the information, it will only be 
necessary to point you to any work on climatology which has been 
written in this country. I doubt if you can overcome such over- 
whelming testimony on this point" 

When authority for some of his statements is requested, the Doc- 
tor's memory is at fault, but as regards the mortality of Jacksonville, 
his memory is perfect. We feel justified in stating that the mor- 
tuary reports of the city of Jacksonville have not been published in 
any medical journal, or the transactions of the Florida Medical Asso- 
ciation. If such "information is so unreliable," it is somewhat 
surprising that a medical gentleman should have hazarded a positive 
and denunciatory statement upon such '■'■unreliable informaUo7i." 

As the authority for the mean relative humidity of this State is " so 
well understood," and as it can be found in ■' any work on climatol- 
ogy, "'t is surprising that Dr. Jones did not refer to some particular 
work, or quote one in his essay. The popular opinion that Florida 
possesses a "moist climate,' is based on the fact that it is partially 
surrounded by water — or on a mere rehash of the statement which 
appeared in the earlier editions of the work of Dr Naphevs, previ- 
ously referred to. The statement that the "atmosphere of l-lorida 
is loaded with moisture," is about as reliable as the statement that the 
"air of Minnesota is dry and desiccating." It is more easy for 
authors to quote and perpetuate errors, than to appeal to the bignal 
Service Department at Washington and secure reliable data. 



58 

situated near the sea coast, and to bolster up high altitudes, 
Dr. Jones quotes the following from Thoroughgood : " At 
Marseilles, the mortality from consumption is 25 per cent." 
Probably Marseilles is one of the most unhealthy towns on 
■ the Mediterranean, yet that recent and eminent authority, 
Dr. Sparks, informs us that the mortality from phthisis in 
that city is but 1 in 74. That in 1876, the garrison in Mar- 
seilles numbered 3,943 men ; that the mortality was 20 per 
1,000, and but three died of phthisis. These figures do not 
support the authority quoted by Dr. Jones. 

Mentone is situated on the Mediterranean, at a very low 
elevation, and is recommended by leading authorities as a 
climatic resort. Its climate, during the cold months, closely 
resembles that of Florida. During a period of twenty-five 
years, we find that 3,189 cases of all kinds were admitted 
into the hospital, and during that period only forty-five 
cases of phthisis — the ratio of phthisis to other diseases was 
as 1 to 75.5. To illustrate the influence of a temperate, 
bracing and dry climate in the treatment of phthisis, I shall 
quote from Sparks, p. 113 : 

CASKS OF PHTHISIS TEEATBD ON THE BEVIKRA. 

Number pr. ct. 

Cured or improved 1,208 62.6 

Stationary or worse 437 22.6 

Dead 284 14.8 

Number of patients 1,929 

Dr. Jones states, p. 280, that " late investigation seems to 
indicate that the comparative infrequency of phthisis among 
inhabitants residing in elevated regions, is due not so much 
to mere altitude as to the absence of organic matter in the 
atmosphere of these high elevations. It is now established 
beyond all doubt, that organic substances, whether gaseous 
products of putrefactive processes, microscopic germs float- 
ing in the atmosphere, when they reach the bronchial tubes 
in the inspired air, are capable of exerting morbid processes 
which lead to serious results. These deleterious organic sub- 
stances, which are constantly inhaled in the lower strata of 
the atmosphere, are one of the strongest arguments against 
sending patients to Florida." The question naturally arises, 
has Dr. Jones, or any other competent observer, examined 
the air of Florida microscopically ? We have not been 
favored with a visit from Ehrenburg, Tyndall, or Angus 
Smith, and Dr. Jones, without any authority or reason, con- 
demns the atmosphere of this State, and endeavors to injure 



59 

Florida as a climatic resort, and as a place of permanent 
residence. Correctly speaking (as regards the surface of 
the earth), the atmo3phere which surrounds St. Paul is no 
higher than that of Jacksonville, but the greater number of 
inhabitants and cesspools in the former, may cause more 
impurity of air than in the latter. If St. Paul was situated 
on an eminence 2,000 to 6,000 feet above the level of the 
adjoining country, Dr. Jones' organism theory would have 
a slight basis. According to the investigations of Ehren- 
burg and Sylvestrie, sand, earth and microscopic organic 
forms can be transported in the atmosphere for long dis- 
tances. The air of Berlin has been found to contain organ- 
isms derived from the African desert. Independent of 
larger substances, the air is found to contain numerous 
living creatures, some lifted from the ground by winds, 
others growing in the air. Ehrenburg discovered over 200 
forms. These can be dried, and retain their vitality for 
years. Minnesota is surrounded by other States where 
organisms do exist, and it requires but a few hours or days 
for the winds to carry objectionable substances from Illi- 
nois, Michigan, New York, Louisiana, or Florida to Minne- 
sota. If Dr. Jones' theory regarding foreign substances in 
the air is correct, Florida is a more suitable place as a 
climatic resort than Minnesota. It is admitted bj all scien- 
tists that foreign substances and minute organisms "are 
more abundant in land than sea air ;" in fact, sea air is 
noted for its purity. Minnesota is surrounded by other 
States, and is favored by the winds with their impurities. 
Florida is nearly surrounded by the ocean, and as it is gen- 
erally fanned by sea breezes, the air must be comparatively 
pure, and Dr. Jones' statement is untenable.* 



* At p. 283, Dr. Jones asks the question : " Why is consumption 
so frequent in Florida?" At p. 289 he answers it, by stating: " It 
need scarcely be repeated, that this marine atmosphere is a fruitful 
source of mischief to consumptives, as indicated by the large death 
rate to those persons residing in situations where this influence is 
operative. It is not surprising that Florida should suffer from this 
scourge, when we remember that it is a peninsula, and therefore ex- 
posed on two sides to this oceanic influence." Florida does suffer 
from a scourge, but it is not phthisis— it suffers from adverse and 
unreliable statements of writers. 

To establish his theory, he asserts, at p. 274, that "consumption is 
unknown in Iceland," and that "Sweden and Norway are almost 
exempt from this disease." He also cites Nova Scotia to prove his 
position. Iceland is surrounded on four sides by water. Sweden 
and Norway form a peninsula ; Nova Scotia is a peninsula, and more 
nearly surrounded by water than Florida. The writer must possess 



60 

The entire gist of Dr. Jones' paper, is to prove that trop- 
ical climates are productive of phthisis ; that they are 
unsuitable for the treatment of phthisis. " That the warm, 
moist climate of Florida acts as an internal poultice, soft- 
ening the morbid mass " [tubercles], and thereby hastening 
the fatal end. " That the effects of a hot, humid atmosphere 
upon the skin, is either to entirely suppress cutaneous per- 
spiration, or to reduce it to a minimum. Indisposition to 
exertion, either physical or mental, due in part to humidity, 
suppression of the insensible perspiration, and to heat, is 
a serious drawback to a patient's improvement. A certain 
amount of exercise in the open air is the sine qua non to the 
successful treatment of a patient with phthisis. Florida 
would be unfit for a patient to visit, for this reason if for no 
other." Dr. Jones' object is apparently to lead the public 
to believe that Florida is a "hot" and "humid " climate. 
But we have proven that the mean relative humidity of 
Florida for the entire year is but 1.7 per cent, above that of 
Minnesota ; and during the cold months, it is 1.8 per cent, 
lower. 

The statements of Dr. Jones will lead his readers to be- 
lieve that Florida is always "hot," and -that the sun is always 
vertical ; but for the five cold months the mean temperature 
for this city is but 58.7 — a close approach to the ideal cli- 
mate recommended by standard authorities for the climatic 
treatment of patients during the winter months.* 

a bad memory, and forget what he stated on p. 274, or else his 
geographical knowledge is defective. His geographical description 
of Florida establishes the fact that he is geographically ignorant of 
the State he denounces. He asserts that Florida is a peuiusnla. It 
possesses a peninsular, and a non-peninsular portion, and the latter is 
300 miles long. 

* Dr. Jones asserts that Florida is " hot," and by this expression 
his readers are led to believe that Minnesota is cool durmg the sum- 
mer months. To illustrate the meteorology of St. Paul, he introduces 
tables for the year 1878, and, for purposes of comparison, we shall 
use data for the same year. 

Maximum temperature for the hot months for year 1878 : 



St. Paul, Minn.... 
Punta Rassa, Fla. 
Key West, Fla.... 
Jacksonville. Fla. 







H 












H 


H 


P 


H 


a 


>j 


P 
< 


Ai 


p 


P 


fA 


•-s 


^-^ 


ZO 


87° 


9()° 


94 ° 


94° 


92 


91 


92 


90 


94 


93 


94 


92 


96 


97 


98. f) 


92 



92.7° 
90.1 { 
93.2 < 93. 
95.9 ( 



From these data it will be seen that the mean of maximum tern- 



61 

In this connection, I cannot refrain from quoting the 
statement of the eminent Prof. Reuhle, of Boun : "The 
investigations of Heirsh, have shown that neither the geo- 
graphical position, nor the temperatuie of a region have 
anything to do with the prevalence of consumption. There 
are regions in all zones which are free from this disease, 
and, on the other hand, there is no zone in which it is not 
very preval^-nt. While it is very rare in Iceland, in the 
island of Marstrand, on the steppes of Kerghis. in the 
interior of Egypt, on the Plateaus of Mexico, Costa Rica, 
in Peru, and in the interior of South Africa, it is, on the 
other hand, very common in Sweden, as well as in India 
and Siberia, as well as in Australia and South America." 
Referring to the causes, a moist atmosphere, currents of air, 
and certain winds, he remarks : " Nothing is known regard- 
ing modus operandi of these causes, except that they pro- 
duce catarrhal and inflammatory respiratory diseases, which 
may become the starting point of consumption, and that 
they are apt to induce a rapid increase when this affection 
already exists." I have quoted from the paper of Dr. Jones, 
and the views of an eminent Professor — a man who was 
considered worthy to be appointed the successor of Prof. 
Neumayer. 

At page 297, Dr. Jones states : "That it is during the 
first stage ol consumption that invalids derive so much ben- 
efit from a visit to Minnesota. I cannot insist too strongly 
upon the inutility of sending phthisical patients to this State 
who are in the advanced stages of the disease. It is my 
belief that when the stage of ulceration and excavation has 
been reached, this climate will do harm." 

Here we have the authority of a distinguished resident of 
Minnesota, that the climate of that State is injurious after 
softening has commenced, and as he condemns Southern 
California, Colorado, Florida, and Mediterranean climatic 
resorts, there is nothing left for a patient, after tubercles 
have commenced softening, but to give up all hope and " set 
his house in order." We opine, that if Dr. Jones would 
vmt Florida, and inhale our " dry, bracing and invigorating 

peratures for Punta Rassa, for year 1878, was 2.6 deg. below St. Paul, 
aud that the mean of three stations in this State exceeded that of St. 
Paul by three-tenths of one degree. But he neglects to inform hi8 
readers that the nights in Florida are cooler and more invigorating 
than in the North and West, and that the days are longer in the 
North than in Florida, and that the rays of the sun in the North are 
longer concentrated on the earth's surface, with a proportionately 
Bhorter night for coolipg by radiation. 



62 

ail'," and question some of our oldest and most experienced 
physicians, he would advise invalids to visit Florida in pref- 
erence to Minnesota. 

I must apologize for occupying so much of your time with 
the assertions of Dr. Jones. But if his views of Florida are 
correct, they should have world-wide publicity, for thereby 
thousands of invalids will be benefited. If his statements 
are incori'ect, common humanity and justice to this State, 
demand that they should be exposed, as they are calculated 
to mislead those who are suffering from a disease which 
annually destroys a large portion of the human family. My 
remarks are not intended to injure Minnesota, but to correct 
the statements of Dr. Jones, pul>lished in a Medical Journal, 
and reprinted in pamphlet form for general distribution. 
His statements have been widely circulated, and if errone- 
ous, they should be contradicted.* 

Other localities in this State may present greater climatic 
advantages and attractions than Jacksonville as a winter 
resort ; yet, as it is the metropolis and objective and dis- 
tributing point of the State, and as definite and reliable 
data can be obtained regarding its meteorology, diseases 
and mortality, I shall offer no apoloy for making a special 
reference to it. 

It possesses a large number of hotels, many of them in 
appointments, home comforts, and cuisine equal those of 
Northern cities. The boarding-houses are numerous and 
comfortable, and in some, the tables are supplied with every 
necessary and luxury. Some benevolent ladies have erected 
a large and well arranged brick hospital, where invalids can 
obtain the comforts of a liome on reasonable terms. The 
river St. Johns affords every facility for rowing and sailing, 
and daily steamboat excursions are made in various direc- 
tions. Through the medium of steamships, steamboats and 
railroads, any portion of the State can be cheaply and com- 
fortably reached. Owing to the location of this city (a few 
miles from the ocean), the easterly winds have to pass over 
the land and are robbed of their saline particles, harshness 
and stimulating effects upon the irritable mucous mem- 
branes of the air passages. Sources of amusement are 
aumei'ous, and the invalid can find means of diverting his 

* I opened a correspondence with Dr. Jones, and in my last com- 
munication, mailed several weeks since, I enclosed reliable and 
official tables illustrating the mean relative humidity of Minnesota 
and Florida, and pointedly asked the s^cntleman if he had not "mis- 
represented the climate of Florida with regard to humidity." Up to 
to-day (Aug. 27th), I have not been favored with a reply. 



63 



attention from his ailments. The mean relative humidity 
of any winter resort is an important factor, and with regard 
to atmospheric humidity, this city has been grossly misrep- 
resented. 

To correct prevailing errors, which have been industri- 
ously propagated by ignorant or interested parties, we shall 
present the following report, kindly furnished by J. W. 
Smith, the intelligent observer in charge of the Signal Sta- 
tion in this city : 

MEAN RELATIVE HUMIDITY OP JACKSONVILLE, 
FLORIDA. 



Years. 


a 


a 

<u 


& 

s 
a 

i-s 


February. 


-a 
o 
;-. 

OS 


1=^ 


Annual mean 


1875, '76 

1876, '77 

1877, '78 

1878, '79 

1879, '80 


per ct. 

78.9 
68.2 
71.8 
70.0 
70.5 


per ct. 
71.1 
64.5 
70.0 
66.3 
74.6 


per ct. 
67.8 
73.6 
67.8 
65.0 
77.1 


per ct. 
70.4 
69.0 
68.5 
65.0 
69.4 


per ct. 

60.2 
63.5 
66.4 
66.0 
63.7 


per ct. 
69.7 

67.8 
68.9 
66.5 
71.1 


year. 
1875 
1876 

1877 
1878 
1879 


pr ct. 
70.3 
67.2 
69.3 
68.7 
69.7 


Mean for 5 
years 


71.9 


69.3 


70.3 


08.4 


63.9 


68.8 




69.0 



Thus, you will perceive that Jacksonville possesses a lower 
mean relative humidity than most of the celebrated winter 
resorts. There is one important point to which I wish to 
direct your attention, and that is the remarkably low per- 
centage of humidity during the much dreaded month of 
March — the mean for five years being but G3.9, as against 
73.3 at Mentone, 76.8 at Atlantic Citv, 79.5 at Breckenridge, 
Minn., 68.4 at Nassau, N. P., and 67.1 at St. Paul. When 
referring to the effects of change of climate, Dr. Madden 
remarks : " The temperature of a locality, to which so much 
importance is popularly assigned, is no criterion of its cli- 
mate as a health resort, the fact being, that invalids are 
painfully sensible of variations in the hygromelric state of the 
atmosphere, which are in no way indicated by the thermom- 
eter, 80 much relied on." 

The thermometric range in this city is not too high nor 
too low. As evidence of this, we find the mean temperature 
for the five cold months, for five years, to be, for November, 
62.1 deg. ; December, 55.8 deg. ; January, 56.2 deg.; Febru- 
ary, 56.9 deg.; March, 62.7 deg.; mean for five months, 
58.7 deg. 



64 

Dr. Lente, p. 17, wben discussing temperature as a con- 
stituent of climate, and referring to certain winter resorts 
north of Florida, remarks : " A mean winter temperature 
of about 48 deg. is too low to entice many of the feeble in- 
valids out of doors, except in calm and sunshiny weather. 
But in some of them, this degree of cold is enhanced, as far 
as the sensations are concerned, by the winds, which fre- 
quently prevail. At such times, most invalids will, there- 
fore, be found hovering over the comfortable wood fires, 
and will be pretty sure to keep all the apertures of their 
chambers closed at night, thus depriving themselves, during 
by far the greater part of the twenty-four hours, of the pi'in- 
cipal means of cure. In Florida, the sun shines so brightly, 
the air is so balmy, the songs of the birds so enlivening, and 
the orange trees in their bloom, or laden with their golden 
fruit, lend such a charm to the outlook from the windows, 
that the most indolent or the most cold-blooded invalid feels 
little inclined to stay indoors." 

Prof. J. Hughes Bennett, of the University of Edinburgh, 
remarks : " And when, in our own country, the question 
arises : Where shall we send the consumptive patient in 
order to avoid our changeable climate and cold winter winds 
in winter ? we naturally say : To a land where, during that 
portion of the year, the weather is warm and equable. 
Much has been written on climate, but the one which ap- 
pears to me best, is that which will enable the phthisical 
patient to pass a few he urs every day in the open air, with- 
out exposure to cold or the vicissitudes of temperature on 
the one hand, or excessive heat on the other.*" 

With the exception of the month of December, fogs are 
seldom seen, and when they do occur, they ai'e not dense, 
and disappear as soon as the sun appears above the horizon. 
Interested parties have intimated that the city of Jackson- 
ville is a "rainy locality," and, in consequence, an "unsuit- 
able place for invalids." To correct this eiTor, we will 
furnish data applicable to a few winter resorts, from reliable 
sources : ^^ 
^b^ 

* Bennett's Practice of Medicine, pp. 326, 476. 



65 



RAIN-FALL IN INCHES AND HUNDREDTHS. 



Nice 

Mentone 

Nervi 

Genoa 

Atlantic City, N. J. 

Augusta, Ga 

Jacksonville. Fla.. 

Key West, Fla 

Punta Rassa, Fla.. 



o 

|i 

28 


a 

> 


l4 
o 

a 

Q 


OS 

1 




o 
2.89 


5.11 


4.12 


3.06 


1.68 


9 


5.34 


3.15 


1.70 


2.18 


4.13 


7 


6.00 


4.88 


4.78 


28.3 


4.49 


29 


7.GI 


4.86 


4.39 


4.27 


3.59 


5 


4.61 


3.60 


2.76 


2.10 


3,86 


5 


4.56 


3.09 


3.70 


3.64 


5.65 


5 


3.02 


3.38 


2.34 


5.14 


2.84 


r> 


2.43 


1.38 


2.18 


2.22 


0.94 


5 


2.38 


0.99 


1.69 


2.67 


1.04 



a 



16.86 
16.. 50 
23.40 
24.72 
16.93 
20.64 
16.62 
9.10 
8.77 



We have referred to sunshine asf an important aid in the 
treatment of disease and broken health, and as an evidence 
that Florida is favored with sunshine and fair weather, and 
not " cloudy, foggy and raiuy weather," as interested parties 
have asserted, I shall direct your attention to the following 
meteorological data, furnished by J. W. Smith, the Observer 
in charge of this station : 

METEOROLOGICAL DATA FROM SIGNAL OFFICE U. S. A., 
JACKSONVILLE, FLA. 



Date. 



1874—18 
187.5—1876 

1876—1877 
1877-1878 
1878—1879 

Average. 



1874—1875 
1875—1876 
1876—1877 
1877—1878 
1878—1879 

Average. 



Rainy days. 



Nov. Dec. Jan. Feb. M'ch 



14 

10 

5 

9 



8.6 



6 

4 

1(» 

9 



7.4 



10 
8 
6 

10 
9 



8.6 



Remarks. 



*' Eainy days," all 
davs on which rain 
fell. 



Cloudy days. 



Nov. 



6 

10 
9 



7.4 



Dec. 


Jan. 


Feb. 


6 


12 


3 


4 


5 


7 


3 


2 


10 


11 


11 


9 


11 


.5 


11 
8. 


7. 


'• 



M'ch. 



7 

10 

4 



6.2 



37.4 days in 5 months 



35.6 cloudy days 5 ms 



J. W. Smith, Observer in charge. 



66 

"Wben a day is raarked "rainy," but a few drops may have 
fallen, and it is no evidence lluit tije entiie day was rainy. 
A measurable or a non-ineasurable quantity njay fall in a 
few minutes, and the remainder of the day be bri^^ht and 
clear. In Florida, the rains are frequently "torrential in 
short severe bursts," followed by brigut and clear weather. 
For the purposes of comparison, wo will refer to the num- 
ber of rainy days during the cold months in Jacksonville, 
Mentone, and St. Paul. 

RAINY DAYS (INCLUDING SNOW.) 




This city is built on a sand bant, where the drainage is 
perfect. In many situations, wells have to be sunk ibrough 
sand to a depth of from fifteen to twenty-two feet before a 
supply of water is obtained. Great attention is paid to 
sanitation, and in this respect Jacksonville is not excelled or 
equalled by any city m the South. Dry-earth closets have 
been enforced by ordinance. Recently the city has been 
effectively sewered, by the laying of drain pipes in the streets 
to carry off storm water and sewage. "Water works of the 
most perfect description have been constructed at a large 
outlay. No layer of clay is found between the surface and 
the permanent water supply, and as a result, the soil is dry 
and warm. The sandy soil upon which tD.e city is built, con- 
tains but a minimum amount of vegetable matter, and, as a 
consequence, health is the rule. To illustrate the mortality 
of this city, I appealed to our efficient and intelligent 
Health Officer, Dr. Knight, and received the following com- 
munication : 

Health Department City of Jacksokville, 

April 10, 1880. 
Dr. G. J. Kenworihy : 

Dear Sir : A careful examination of the Mortuary Re- 
ports in the City Sexton's office, reveals the following facts : 



•Dr. Jones, N. Y. Med. Jour,, lb79, p. 2S7r 
LofC. 



67 

Previous to 1878, the records were imperfectly kept and are not 
reliable. 

^ ortality for 1878 119 

Blortality for 187i) 171 

Mortality for two years 290 

Di'diu-t from this Duniher visitors who died of phthisis, 

IriglH's disease and organic disease of the heart 40 

Total mortality of residents 250 

Percentage of mortality among residents for two years, per 1,000. .12.5 
Percentage of deatlis from pUlhisis among residents, per 1,000 ...0.55 
Percentage of deaths from pulmonary diseases, other than 

phthisis, per t,000 1.4 

l-iespectiully yours, 

A. \V. Knight, M. D., Health Officer.* 

*As this paper is going throuiih the press, I deem it advisable to 
refer to the mortality of Florida and Minnesota. At p. 277, Dr. Jones 
asserts that "Florida, which has been so much vaunted as a sanita- 
rium for invalids, shows a greater ratio of mortality from phthisis 
today than Jlinnesota." At the time this statement was written, fig- 
ures were not available upon which a statement of this description 
could be bised. 

To confirm or disprove the statement of Dr. Jones, regarding tho 
mortality of Florida and Minnesota, I had a compilation of the cen- 
sus returns made by a competent person ; and a friend favored me 
with a compendium of the Vital Statistics of Minnesota for the year 
1871). I will append the data and allow the public to form an un- 
biased opinion. 

FLORIDA. 

Mortality per 1,0^0 from all causes 9.2 

Diaths per 1,000 from consumption, including invalid visitors.. O.GO 

Deaths per l,0i)0 from consumption, exclading visitors who 
came to the Slate in the last and an incurable stage of this 
disease 0.44 

Deaths per 1,000 from pulmonary diseases, other than consump- 
tion 0.50 

Deaths per 1.000 among residents from pulmonary diseases, in- 
cluding consumption 0.94 

There was one death from consumption, including visitors, to 

15.2 from all causes. 
There was one death from consumption among residents, to 18.2 

from all causes. 
There was one death from pulmonary diseases, to 8.2 from all causes. 

MINNESOTA. 

Mortality per 1,000 from all causes 11.2 

Mortality per 1,000 from consumption 1. 12 

Mortality per J, 000 from pulmonary diseases, other than con- 
sumption 0.65 

Deaths per l,iioo from all pulmonary diseases 1.77 

There was one death from consumption to ten from all causes. 
There was one death from pulmonary diseases to six from all cau.se8. 
It is gratifying to fiiud that the mortality of Minnesota is so low; 
and that Florida "to-dav" holds the prominent position for salubrity 
that she did in 18G0 and" 1870. 



68 



Since this paper was printed, the semi-monthlv Mortuary 
Beport of the cit}' of Jacksonville has been published by 
Dr. Knight, and we find that the 

Death rate of the first six months of the present year was, per 
1,000 10.6 

Deduct from total deaths 37 nou-residents, who died of phthisis 
and chronic heart disease, and the actual mortality among 
residents was 6.9 

Deaths from consumption among residents 0. 

During the years '78 and '79, the mortality from phthisis 
among residents was surprisingly low — 0.55 — a fraction over 
one-half of one per cent, per 1,000, and for the first six 
months of 1880, not a death occurred among the resident 
population from consumption. Dr. Jones' statements re- 
garding the great mortality from phthisis in this State, more 
especially among " old families, that have resided in the State 
for generations," is not sustained by the above reliable data. 

It is gratifying to find that the mortality i'rom phthisis 
and other pulmonary diseases is so low, more especially as 
it has been denounced as an unsuitable climate for the treat- 
ment of such cases, and the public led to believe that 
phthisis is of frequent occurrence here. If the mortality 
from these diseases is so light, it is evident that the climate 
must be favorable for invalids suffering from such affections. 
To illustrate the mortality of a number of cities, we shall 
quote from the Annual Health Report from the city of 
Yonkers, for 1879, " showing the vital statistics of American 
cities for the year 1879 :" 

Cities. Rate per 1,000. 



Cities. 



Kate per 1,000. 



New York, N. Y 24.93 

Brooklyn, N. Y 20.1.5 

Buffalo, N. Y U.l'J 

Rocliester, N. Y 1G.24 

Yonkers, N. Y 14.1G 

Plattsburgh, N. Y 2.5.00 

Newburgh, N. Y 17 30 

Boston, Mass 21.. 53 

Worcester, Mass = .19.25 

Cambridge, Mass 19. 67 

Lynn, Mass 18 G3 

Newburyport, Mass ...17.11 

Concord, N. H 13.20 

Burlington, Vt lO.GS 

Hudson county, N. J 20.0S 

New Haven, Conn 17.99 

Hartford, Conn 10. 07 

Providence, R. 1 19.89 

Philadelphia, Pa 17.9G 

Pittsburgh, Pa 21.16 



Wilmington, Del 21.02 

District of Columbia 26..58 

Richmond, Va 18.40 

Norfolk, Va 21.91 

Milwaukee, Wis 14.35 

Cincinnati, 17.23 

Cleveland, O 16.72 

Baltimore, Md 21.,53 

Evausville, Ind 19.52 

Chicngo, 111 16..50 

St. Louis, Mo 12.00 

Salt Lake City 14.00 

San Francisco, Cal 15.80 

New Orleans, La .50.17 

Mobile, Ala 23.05 

Savannah, Ga 30.25 

Charleston, S. C 29.16 

Nashville, Tenn 23.11 

Jacksonville, Fla 12.5* 



69 

To illustrate the mortality from plithisis in a few cities, 
we shall quote from Copeland's Dictionary of Practical Med- 
icine : 

la Berlin, there was 1 death from phthisis to 5.7 deaths 
from all causes ; in London, 1 to G.2 ; Paris, 1 to 5.5 ; 
Hamburgh, 1 to 4.6 ; Stuttgardt, 1 to 4.7 ; New York, 1 to 
5.0 ; Philadelphia, 1 to 7.7 ; Baltimore, 1 to 6.7 ; Boston, 1 
to 5.9 ; Florence, 1 to 11.5; Jacksonville,* including invalid 
visitors, 1 to 0.44 ; in Jacksonville there was one death from 
phthisis among residents to 0.10, and for the first six months 
of this year, not a death among residents. 

As a result of having expressed myself so positively re- 
garding the influence of climate in the treatment of disease, 
you must not conclude that I am disposed to ignore the use 
of drugs and rational medication. How often do we see 
invalids at a health resort deluding themselves with the idea 
that climate alone will effect a cure. In some cases, patients 
are ordered to a winter resort without any instructions for 
their guidance, save to '' throw physic to the dogs." When 
patients reach a climatic resort, they fancy themselves re- 
leased from the observance of medical rules, which are as 
necessary at health resorts as at their homes. They do not 
seem to realize the fact that they ai'e invalids, and that they 
have left homes and friends to regain their health, but they 
thoughtlessly expose themselves, indulge their appetites, 
and are guilty of many imprudent acts. Through their own 
waywardness and imprudence, they aggravate disease, and 
the climate is censured. The invalid who seeks climatic 
change for the relief of his disease, should remember the old 
Salernitan precept : 

" Si iibi deficiant medici, medici tibi fiant, 
Hcec tria, mens laeta, requires moderata dieta." 

Much may be done by physicians at climatic resorts to 
aid patients in regaining their health, when suffering from 
phthisis, in the way of regulating exercise and bathing, 
recommending suitable points for residence, restoring the 
tone of the digestive organs, directing the quantity and 
quality of food, relieving cough and myalgia,, arresting night 
sweats, haemoptysis, and diarrhoea, the treatment of dia- 
thetic states, and last, though not least, the improvement of 
nutrition. 

In this State, we have favorable climatic factors to nid in 
the cure of disease, and it rests with you, gentlemen, to 

* Report of Dr. Knight, Health Officer. 



70 

maintain and guard the g;ood reputation of the "American 
Itally " — to keep pace with the rapid strides of pulmonary 
diagnosis, pathology and therapeutics, so that those who are 
intrusted to your cai-e, may receive the benefits of enlight- 
ened and rational treatment. 

Facility (f access of a health resort is a matter of great 
importance. It is obvious that a patient should be sent to 
a locality which can be reached by an easy journey, and in 
case of need, communicate with home and be reached by 
friends. In this respect our favored State possesses many 
advantages It can be easily and rapidly reached from the 
Korth and West by through trains and sleeping-cars, and 
from Boston, New York, Philadelphia, Baltimore and New 
Orleans, by fast, staunch and palatial steamships. 



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Each is provided with an Electric Light which enables them to use the night 
tides in Savannah River when necessary. 

The average passage between New York and Savannah is less than sixty 
hours. 

Through Bills Lading and Tickets over Central Railroad of Georgia, Sa- 
vannah, Florida & Western Railway, Inland and Outside Steamers to Florida. 

For information apply to 

GEO. YONGE, Af/ent, G. M. SOBREL, Agent, 

Pier 35, New York. Savannah, Ga. 

HEN BY YONGE, Jr., General Agent, 

No. 317 Broadway, New York. 



MERCHANTS AND MINERS 

TRANSPORTATION CO. 




The Steamships of this Company ply regularly between 

Savannah and Baltimore, 

Baltimore and Boston, and 

Baltimore and Providence. 

Leaving Savannah and Baltimore every Five Days. 



The Baltimore Eo^ite Is the Iilost Direct between the U ad West. It 
is also the most Economical and Quickest. 



The Steamers are first-class in every respect, with excellent accommo- 
dations for Passengers. Reduced Rates of Passage to 
Emigrants from Baltimore and all 
Points West and Southwest. 



This Company's Steamers are specially arranged for the transportation of 
Fruit and Vegetables, and Through Bills of Lading, at low rates, will be 
issued. 

A. L. HUGGIiNS, Agrent, JAS. B. WEST & 00., Agents, 

Baltimore, Md. 114 Bay St., Savannah. 



THE mm SEAT or m county, Florida, 



IS A THRIVING VILLAGE, WITH 



fWi i^ffii Ml lit? 

Comfortable Boarding Houses, 
IHREE OB FOyR CHURCHES, DAIEY MAILS AND A TELEGRAPII ! 



It is situated on the "West bank of the St. Johns- 
Eiver, thirty miles South of Jacksonville, and a dozen 
or more Steamboats stop at its wharves dail3\ 

The water of the celebrated White Sulphur Spring, 
tlie flow from which is equal tojhree thousand gallons per 
minute, has long been noted for its efficacy in Rheu- 
matism and Kidney Affections. The temperature of the 
water remaining uniformly at 72^, Bathing in the "Swim- 
ming Pools" is enjoyed throughout the year. Hot Baths 
are supplied, to those who prefer them, in the Clarendon 
Hotel, which fronts upon the Spring grounds. 

Dr. S. Rogers is Resident Physician during the Winter 
Season. 

Dr. W. D. Colmar, of Florida, and Dr. M. O. Arnold, 
recently of Iowa, reside here permanently. 

The town of Green Cove Spring is located on what is 
known as the Bayard Tract. This body of land was 
granted by the Spanish government to the Surveyor- 



General of the Colony. Shortly after Florida was ceded 
to the United States, the tract was purchased from the 
grantee by General D. L. Clinch, The grant was sub- 
sequently confirmed by the Supreme Court of the United 
States. The title of the present owner, the son of Genj 
Clinch, is therefore perfect. 



DURING THE SUMMER OF 1880, 

h M was IMM into Lois of 23 d iO Hofos, 

WHICH ARE NOW 
BY THE UNDERSIGNED AS AGENT FOR COL. HOUSTOUN CLINCH^ 

THESE LOTS COMl'RISE 

ill Hiisi §1 ilfii ifiil 

AFFORDING BEAUTIFUL SITES FOR RESIDENCES AND 

ORANGE GROVES. ' 
TI-IOTJSillTDS cr* ACnSS O^ RIDGE Z^JLHTD. 

No land in Florida is better adapted to the cultiva- 
tion of the Orange, and no locality anywhere can be more 
healthy. 

Large bodies of the best Sugar, Cotton, Corn and 
Vegetable Land in East Florida. 



TOWN LOTS IN GREEN COVE SPRINGS. 



77ie most beatitiful River F^ont o/t the St. jto/ins. 
ALSO, A NUMBER OF IMPROVED FARMS. 

For fuller information address 

C, C. ^JEMIS, ^^gertt, 

Green Cove Spring, Clay County, Fla. 



PHILADELPHIA AND SOUTHERN MAIL 

STEAMSHIP COMPANY. 



steamship JUNIATA, - Capt. J. W. Catharine. 
Steamship CHAS. "W. LORD, ■ Capt. L. Colton. 

These first-class and finely-appointed Steamers ply regularly between 
PHILADELPHIA and SAVANNAH, leaving each port on SATURDAY. 

connecting at Savannah with the 

CENTRAL RAILROAD OF GEORGIA, 

SAVANNAH, FLORIDA & WESTERN RAILWAY, 

And FLORIDA STEAMERS. 

Through Passage Tickets and Bills of Lading issued to All Principal 
Points South and Southwest at rates as low as the published rates of 
competing lines. JJ®-- THROUGH TICKETS from 

Including transfer o. Passengers and Baggage from Steamer's Wharf to 
Railroad Depot at Philadelphia, can be obtained of the Agents of the Line at 
Savannah. SUPERIOR CABIN and STEERAGE ACCOMMODA- 
TIONS. Apply to or address WM. L. JAMES, 

General Agent, 424 South Delaware Avenue, Philadelphia. 

WM. HUNTER & SON, 

100 Bay Street, Savannah, Ga. 



3477-26S 
Lot 1^ 











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